Does availability of point of care C-reactive protein measurement affect provision of antibiotics in a community respiratory service?

Br J Community Nurs. 2022 May 2;27(5):218-224. doi: 10.12968/bjcn.2022.27.5.218.

Abstract

Antibiotic resistance presents a growing threat to health systems and patients at a global scale. Point of care (POC) C-reactive protein (CRP) measurement, as an adjunct to exacerbation assessment, has been studied in primary and secondary care and may represent a useful tool for community teams. A retrospective service review was conducted to determine the effect of CRP measurement on antibiotic provision in a community respiratory setting, with chronic obstructive pulmonary disease (COPD) and bronchiectasis exacerbations. This review compared antibiotic provision for COPD and bronchiectasis patients for those where CRP was measured versus those where it was not. It was found that antibiotic provision dropped by almost 25% points for COPD exacerbations, and almost 59% in bronchiectasis, when a CRP measurement was taken as a component of a respiratory assessment. Antibiotics were also provided at a greater amount based on symptom presentation. Therefore, it is concluded that CRP measurement correlates with a reduction in antibiotic provision, highlighting its use alongside symptom assessment in future work.

Keywords: Antibiotics; Bronchiectasis; COPD; CRP; Exacerbations; Respiratory.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bronchiectasis* / complications
  • Bronchiectasis* / drug therapy
  • C-Reactive Protein / analysis
  • Disease Progression
  • Humans
  • Point-of-Care Systems
  • Pulmonary Disease, Chronic Obstructive* / complications
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents
  • C-Reactive Protein