C-reactive protein point of care diagnostics aids in the prevention of Antimicrobial Resistance

Antimicrobial resistance is a growing global health threat requiring immediate actions. In healthcare, proper use of antibiotics is a key factor in fighting against antibiotic resistance. C-reactive protein point of care testing increases diagnostic certainty, optimizes antibiotic use and aids in the management of respiratory infections in different healthcare settings. NICE guidelines recommend C-reactive protein point of care testing in the management of lower respiratory infections.

Antimicrobial resistance is a global health threat
Antimicrobial resistance (AMR) is a growing global health threat that has already reached alarming magnitude. It is estimated that even 1.27 million deaths were directly associated with antibiotic resistance worldwide in 2019. World Health Organization (WHO) has declared AMR as one of the top 10 current global health threats.

Over- and misuse of antibiotics has led to the development of bacterial strains resistant to available antibiotics. Therefore, many common infections that are currently treated with antibiotics may become life-threatening. In addition to increased mortality, AMR causes a huge economic burden for both healthcare systems and individual people: patients require longer hospitalization and have a loss of income due to their prolonged illnesses.

Antibiotic overprescribing in primary care
About 80-90% of all antibiotics are prescribed in primary care, where majority of antibiotics are used to treat respiratory infections, such as sore throat, pharyngitis, bronchitis, sinusitis, and otitis media. Treatment decisions based only on clinical assessment of the patient, without diagnostic confirmation, are still relatively common.

Approximately 90% of respiratory infections have viral origin or are self-limiting and cannot be cured by antibiotics. It is estimated, that 50% of all prescribed antibiotics are unnecessary or prescribed against the clinical guideline recommendations. Treatment of viral and self-limiting infections with antibiotics does not provide any clinical benefit for the patients. Instead, unnecessary treatment enhances the development of AMR.

Diagnostic uncertainty drives AMR
Differentiation of respiratory infections that require antibiotic treatment from the viral and self-limiting infections is often difficult. Diagnostic uncertainty is the main driver of antibiotic overprescribing in primary care. When physician is uncertain whether to prescribe antibiotics or not, antibiotics are often prescribed just in case to minimize risk for the patients and avoid malpractice. Also, patients often demand antibiotics in cases when they are not needed. Consequently, the combination of diagnostic uncertainty and patient’s pressure for antibiotic treatment easily results to overprescribing.

C-reactive protein point of care testing optimizes antibiotic use
In healthcare, proper use of antibiotics is a key factor in fighting against antibiotic resistance. Antibiotics should be prescribed and used only when truly needed and only for bacterial infections. C-reactive protein (CRP) is an acute phase plasma protein used as a diagnostic marker for infection, inflammation, and tissue injury. CRP level increases in bacterial infections proportionally to the severity of the infection. When CRP is measured at the initial visit and used together with the clinical assessment of the patient, it is a useful tool to guide antibiotic prescribing.

CRP point of care (POC) testing has been shown to decrease antibiotic prescribing for respiratory infections by approximately 25% in primary care in adults without causing harm to the patients. CRP POC testing is an effective tool to optimize antibiotic prescribing, improve the management of respiratory infections, and promote antimicrobial stewardship in health care.

CRP POC testing aids management of respiratory infections
Aidian provides QuikRead go® test system with a selection of different accurate and precise CRP POC tests for healthcare professionals with different needs. With fast QuikRead go CRP POC tests, results are available within 2 minutes during the patient’s visit at the physician. Immediate result aids in the treatment decision making and increases the diagnostic certainty of the physician. In addition, CRP POC test results can be used as a tool when a physician communicates to the patient why antibiotics are not needed. The National Institute for Health and Care Excellence (NICE) has a technical briefing MIB78 about QuikRead go CRP published in 2016.

CRP POC testing recommendations in clinical guidelines
NICE recommends CRP POC testing in the following guidelines: Diagnosis and management of pneumonia (CG191) and Cough (acute): antimicrobial prescribing (NG120). CRP POC measurement is recommended after the clinical assessment of the patient to identify those with pneumonia and who require antibiotic treatment. In acute cough, CRP is recommended for ruling out pneumonia in cases when the diagnosis is unclear after clinical assessment.

CRP POC testing and AMR
AMR is an urgent threat that requires immediate actions to be tackled. Fast CRP POC testing before antibiotic prescribing is one effective way to guide prudent and sustainable use of antibiotics and prevent the development of AMR.

Aidian’s QuikRead go CRP products are fast, accurate, and easy to use POC tests for the management of respiratory infections in different healthcare settings.

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