Trial reportBMJ (Clinical research ed.)2021
Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents: cluster randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 29 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 4 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- A systematic review and meta-analysis on diagnostic accuracy of point-of-care C-reactive protein devices for acute respiratory tract infections.Infection · 2026Pooled it
- Rapid tests to inform triage and antibiotic prescribing decisions for adults presenting with suspected acute respiratory infection: a rapid evidence synthesis of clinical effectiveness and cost-utility studies.Health technology assessment (Winchester, England) · 2025Pooled it
- Pooled it
- Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care.The Cochrane database of systematic reviews · 2022Pooled it
- Clinicians' perspectives on a primary healthcare intervention to reduce antibiotic prescription for acute lower respiratory tract infections in Barcelona (Spain): a qualitative study.Primary health care research & development · 2025Trial
- Biomarker guided antibiotic stewardship in community acquired pneumonia: A randomized controlled trial.PloS one · 2024Trial
- Trial
- Is C-reactive protein the answer to antibiotics over-prescribing in primary care? A behavioural experiment in two European countries.JAC-antimicrobial resistance · 2026Article
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- Effect of a comprehensive package based on combined C-reactive protein and serum amyloid A point-of-care testing on antibiotic prescribing for acute respiratory tract infections at village clinics in China: a cluster randomised controlled trial.The Lancet regional health. Western Pacific · 2026Article
- Point-of-Care Diagnostic Technologies for Antimicrobial Resistance: Principles, Platforms, Clinical Impact, and Future Directions.Diagnostics (Basel, Switzerland) · 2026Review
- ERS Congress 2025: highlights from the Respiratory Infections Assembly.ERJ open research · 2026Article
- Guidelines for the Initial Assessment of Respiratory Distress in the Emergency Department.Annals of intensive care · 2026Article
- Article
- Article
- Article
- Antibiotic use for respiratory tract infections in nursing homes: a multicentre cross-sectional study.Frontiers in pharmacology · 2025Article
- Antimicrobial prescribing in French nursing homes and interventions for antimicrobial stewardship: a qualitative study.Antimicrobial resistance and infection control · 2024Article
- Impact of Lung Ultrasound along with C-Reactive Protein Point-of-Care Testing on Clinical Decision-Making and Perceived Usefulness in Routine Healthcare for Patients with Lower Respiratory Tract Infections: Protocol for Analytical Observational Study.Journal of clinical medicine · 2024Article
- Role of biomarkers in antimicrobial stewardship: physicians' perspectives.The Korean journal of internal medicine · 2024Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
7 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate whether C reactive protein point-of-care testing (CRP POCT) safely reduces antibiotic prescribing for lower respiratory tract infections in nursing home residents.
designPragmatic, cluster randomised controlled trial.
settingThe UPCARE study included 11 nursing home organisations in the Netherlands.
participants84 physicians from 11 nursing home organisations included 241 participants with suspected lower respiratory tract infections from September 2018 to the end of March 2020.
interventionsNursing homes allocated to the intervention group had access to CRP POCT. The control group provided usual care without CRP POCT for patients with suspected lower respiratory tract infections.
main outcome measuresThe primary outcome measure was antibiotic prescribing at initial consultation. Secondary outcome measures were full recovery at three weeks, changes in antibiotic management and additional diagnostics during follow-up at one week and three weeks, and hospital admission and all cause mortality at any point (initial consultation, one week, or three weeks).
resultsAntibiotics were prescribed at initial consultation for 84 (53.5%) patients in the intervention group and 65 (82.3%) in the control group. Patients in the intervention group had 4.93 higher odds (95% confidence interval 1.91 to 12.73) of not being prescribed antibiotics at initial consultation compared with the control group, irrespective of treating physician and baseline characteristics. The between group difference in antibiotic prescribing at any point from initial consultation to follow-up was 23.6%. Differences in secondary outcomes between the intervention and control groups were 4.4% in full recovery rates at three weeks (86.4%
conclusionsCRP POCT for suspected lower respiratory tract infection safely reduced antibiotic prescribing compared with usual care in nursing home residents. The findings suggest that implementing CRP POCT in nursing homes might contribute to reduced antibiotic use in this setting and help to combat antibiotic resistance.
trial registrationNetherlands Trial Register NL5054.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.