C-reactive protein point-of-care testing to guide antibiotic prescribing for respiratory tract infections

Area of Science:

• Primary Care Medicine
• Infectious Diseases
• Clinical Diagnostics

Background:

• Antimicrobial resistance is a significant global health threat, closely linked to antibiotic consumption.
• The majority of antibiotic prescriptions are issued in primary care settings, often for viral respiratory tract infections (RTIs) where they are not indicated.

Purpose of the Study:

• To review the evidence on the utility of C-reactive protein (CRP) rapid testing in primary care for managing patients with RTIs.
• To assess the role of CRP testing in reducing unnecessary antibiotic prescribing and mitigating antimicrobial resistance.

Main Methods:

• A comprehensive literature search and narrative review of studies on CRP rapid testing for RTIs in primary care.
• Analysis of evidence up to April 2025, focusing on clinical utility and impact on antibiotic prescribing.

Main Results:

• CRP rapid testing is an effective and cost-efficient method to decrease unnecessary antibiotic use for lower RTIs in primary care.
• The test supports clinical decision-making, complementing patient history and examination to rule out serious infections.

Conclusions:

• CRP rapid testing should be integrated into clinical guidelines for managing RTIs when antibiotic prescription is uncertain.
• Implementation requires clear guidance, clinician training in communication, and consideration of delayed prescribing strategies to combat antimicrobial resistance effectively.