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C-Reactive Protein Point of care Testing and complementary strategies in adults
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- Andreeva E and Melbye H. Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group. BMC Family Practice 2014; 15:80.
- Bisgaard L, Andersen CA, Jensen MSA, Bjerrum L, Hansen MP. Danish GPs’ Experiences When Managing Patients Presenting to General Practice with Symptoms of Acute Lower Respiratory Tract Infections: A Qualitative Study. Antibiotics 2021; 10, 661.
- Bjerrum L et al. Re: Impact of C-reactive protein point-of-care testing on antibiotic prescriptions for children and adults with suspected respiratory tract infections in primary care by Jung et al., Clinical Microbiology and Infection 2024
- Boere T, Hopstaken R, van Tulder MW et al. 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. BMJ 2021;374:n2198;
- Butler C et al. C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations. N ENGL J MED 2019; 381(2): 111-120
- Cals JW, et al. Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial. BMJ. 2009;338(51):137.
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- Christensen LD, Vestergaard CH, Keizer E et al. Point-of-care testing and antibiotics prescribing in out-of-hours general practice: a register-based study in Denmark. BMC Primary Care 2024;25:31
- Cooke J, Sheraz M, Hill J, Lawton K. Community Pharmacists working with GPs reduce Antibiotic Prescribing for RTIs using CRP Point-of-Care-Testing. JPHP 2019; Supplement s1: 6–13; Poster abstract S6.
- Cronberg O, Tyrstrup M, Ekblomb K et al. Factors influencing antibiotic prescribing for respiratory tract infections in primary care – a comparison of physicians with different antibiotic prescribing rates. Scandinavian Journal of Primary Health Care 2024;42(3):424–434
- Dewez JE, Nijman RG, Ftichett EJA et al. Adoption of C‑reactive protein point‑of‑care tests for the management of acute childhood infections in primary care in the Netherlands and England: a comparative health systems analysis. BMC Health Services Research 2023;23:191
- Dixon S, Fanshawe TR, Mwandigha L et al. The Impact of Point-of-Care Blood C-Reactive Protein Testing on Prescribing Antibiotics in Out-of-Hours Primary Care: A Mixed Methods Evaluation. Antibiotics 2022;11: 1008
- Do NTT, Vu TVD, Greer RC et al. Implementation of point-of-care testing of C-reactive protein concentrations to improve antibiotic targeting in respiratory illness in Vietnamese primary care: a pragmatic cluster-randomised controlled trial. Lancet Infect Dis 2023. S1473-3099(23)00125-1
- Gentile I, Schiano Moriello N, Hopstaken R, Llor C, Melbye H, Senn O. The Role of CRP POC Testing in the Fight against Antibiotic Overuse in European Primary Care. Recommendations from a European Expert Panel. Diagnostics 2023; 13(320).
- Gilham EL, Pearce-Smith N, Carter V, Ashiru-Oredope D. Assessment of global antimicrobial resistance campaigns conducted to improve public awareness and antimicrobial use behaviours: a rapid systematic review. BMC Public Health 202424:396
- Greer RC, Althaus SD, Butler CC et al. The impact of C-reactive protein testing on treatment seeking behavior and patients’ attitudes toward their care in Myanmar and Thailand. Health care in Low-resource Settings 2023; 11:11278
- Hopstaken R. A Simple Point-of-care Test to Help Combat Antibiotic Resistance. Scientia 2022.
- Jung C et al. Impact of C-reactive protein point-of-care testing on antibiotic prescriptions for children and adults with suspected respiratory tract infections in primary care: a French patient-level randomized controlled superiority trial. Clinical Microbiology and Infection 2024
- Landendörfer W, Dänschel I, Grebe IG. Positionspapier: Erstattung von quantitativer CRP-Testung am Point-of-Care zur Reduzierung von Antibiotikaverordnungen und zur Vermeidung von Antibiotikaresistenzen. Stand 23.12.2024
- Lapi F, Marconi E, Rossi A et al. The use of C-reactive protein testing and antibiotic prescribing in Italy: A population-based study in primary care. Br J Clin Pharmacol 2024;e16166
- Little P, et al. Effects of internet-based training on antibiotic prescribing rates for acute respiratory-tract infections: a multinational, cluster, randomised, factorial, controlled trial. The Lancet 2013;382(9899):1175-1182.
- Llor C, Benk˝o R and Bjerrum L (2024) Global restriction of the over-the-counter sale of antimicrobials: does it make sense? Front. Public Health 202412:1412644
- Llor C, Frimodt-Møller N, Miravitlles M, Kahlmeter G and Bjerrum L. Optimising antibiotic exposure by customising the duration of treatment for respiratory tract infections based on patient needs in primary care. eClinicalMedicine 202474:102723
- Llor C, Hansen MP, Lykkegaard J et al. Duration of antibiotic treatment for respiratory tract infections in primary care. JAC Antimicrobial Resist 20257(1)
- Llor C, Moragas A, Cots JM, López-Valcárcel BG, Happy Audit Study Group. Estimated saving of antibiotics in pharyngitis and lower respiratory tract infections if general practitioners used rapid tests and followed guidelines. Aten Primaria. 2017;49(6):319-325.
- Llor C, Moragas A, Cots JM. Implementation of the delayed antibiotic prescribing strategy. Prospective observation study in primary care. Revista Española de Quimioterapia Rev Esp Quimioter 2022;35(2):213-217.
- Llor C, Plate A, Bjerrum L, Gentile I, Melbye H, Staiano A, van Hecke O, Verbakel JY, Hopstaken R. C-reactive protein point-of-Care testing in primary care - broader implementation needed to combat antimicrobial resistance. Front. Public Health 2024;12:1397096
- Llor C, Plate A, Bjerrum L, Gentile I, Melbye H, Staiano A, van Hecke O, Verbakel JY, Hopstaken R. C-reactive protein point-of-Care testing in primary care - broader implementation needed to combat antimicrobial resistance. Front. Public Health 2024;12:1397096
- Lykkegaard J, Kanstrup Olsen J, Vognbjerg Sydenham R, Plejdrup Hanse M. C-reactive protein cut-offs used for acute respiratory infections in Danish general practice. BJGP Open 2021
- Markwart R, Lehmann LS, Krause M et al. Utilization and consequences of CRP point-of-care testing in primary care practices: a real-world multicentre observational study with 1,740 patient cases in Germany. BJGP OPEN BJGPO 2024;0120
- Martínez-González N, Plate A, Jäger L et al. The Role of Point-of-Care C-Reactive Protein Testing in Antibiotic Prescribing for Respiratory Tract Infections: A Survey among Swiss General Practitioners. Antibiotics 2022;11:543
- Matthes A, Wolf F, Wilde E, et al. Point-of-care measurement of C-reactive protein promotes de-escalation of treatment decisions and strengthens the perceived clinical confidence of physicians in out-of-Hours outpatient emergency medical services. BMJ Open 2023;13:e069453.
- Molero JM, Moragas A, López‐Valcárcel BG, et al. Reducing antibiotic prescribing for lower respiratory tract infections 6 years after a multifaceted intervention. Int J Clin Pract. 2019;e13312.
- Morell L, Buchanan J, Roope LSJ, et al. Delayed Antibiotic Prescription by General Practitioners in the UK: A Stated-Choice Study. Antibiotics 2020; 9, 608.
- O’Neill K, Fleming G, Scott M, Plant G, Varma S. C-reactive protein point of care testing in community pharmacy: Observational study of a Northern Ireland pilot. Pharmacy Practice 2022;20(4):2711.
- Olliario P, Nkeramahame J, Salami O et al. Advancing Access to Diagnostic Tools Essential for Universal Health Coverage and Antimicrobial Resistance Prevention: An Overview of Trials in Sub-Saharan Africa. CID 2023:77(2): 125-133
- Onwunduba A, Ekwunife O, Onyilogwu E. Impact of point-of-care C-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomize d controlled trial. International Journal of Infectious Diseases 2023127137–143
- Plate A, Di Gangi S, Garzoni C et al. Patient leaflets on respiratory tract infections did not improve shared decision making and antibiotic prescriptions in a low‑prescriber setting. Scientific Reports 20244.04027777777778
- Salami et al. Impact of a package of diagnostic tools, clinical algorithm, and training and communication on outpatient acute fever case management in low- and middle-income countries: protocol for a randomized controlled trial. Trials 2020; 21:974.
- Schwartz KL, Xu AXT, Alderson S, Bjerrum L et al. Best practice guidance for antibiotic audit and feedback interventions in primary care: a modified Delphi study from the Joint Programming Initiative on Antimicrobial resistance: Primary Care Antibiotic Audit and Feedback Network (JPIAMR-PAAN). Antimicrobial Resistance & Infection Control 2023;12(72)
- Scottish Antimicrobial Prescribing Group. EXECUTIVE SUMMARY: Evaluation of C-reactive protein (CRP) in primary care settings to support reduction of antibiotic prescribing for self-limiting respiratory infections. July 2016.
- Spurling GKP, Del Mar CB, Dooley L, Clark J, Askew DA. Delayed antibiotic prescriptions for respiratory infections. Cochrane Database of Systematic Reviews 2017; Issue 9. Art. No.: CD004417.
- Stollberg SM, Graber SM, Kronenberg A et al. Discrepancy between antibiotic pack sizes and guideline recommendations: a real-world analysis based on claims data. Infection 2024
- Stuart B, Hounkpatin H, Becque T, et a. Delayed antibiotic prescribing for respiratory tract infections: individual patient data meta-analysis. BMJ 2021;372:n808.
- Sydenham RV, Hansen MP, Justesen US et al. Factors associated with C-reactive protein testing when prescribing antibiotics in general practice: a register-based study. BMC Prim Care 2022;22;23(1):17
- van der Velden AW, van de Pol AC, Bongard E et al. Point-of-care testing, antibiotic prescribing, and prescribing confidence for respiratory tract infections in primary care: a prospective audit in 18 European countries. BJGP Open 2022;6(2)
- Van Duffel L, Yansouni CP, Jacobs J et al. Accuracy of C-reactive Protein and Procalcitonin for Diagnosing Bacterial Infections Among Subjects With Persistent Fever in the Tropics. Open Forum Infect Dis 2022;24;9(9):ofac434
- Van Hecke O, Bjerrum L, Gentile I, Hopstaken R, Melbye H, Plate A, Verbakel JY, Llor C and Staiano A. Guidance on C-reactive protein point-of-care testing and complementary strategies to improve antibiotic prescribing for adults with lower respiratory tract infections in primary care. Front. Med 2023;10:1166742.
- Van Hoof V, Barglazan D, Blairon L. Organisation and quality monitoring for point-of-care testing (POCT) in Belgium: proposal for an expansion of the legal framework for POCT into primary health care, Acta Clinica Belgica 2021
- Van Hoovels L, Massa B, Stavelin A, De Meyer H, De Schrijver P, Van Laethem V, Barglazan D, Gruson D, Hopstaken R, Peeters B, Van Hoof V, Verdonck A, Verbakel JY. Analytical performance and user-friendliness of four commercially available point-of-care devices for C-reactive protein. Clinica Chimica Acta 2024;560:119737
- Veimer Jensen ML, Aabenhus RM, Holzknecht BJ, Bjerrum L et al. Antibiotic prescribing in Danish general practice in the elderly population from 2010 to 2017. Scandinavian Journal of Primary Health Care 2021;39 (:4): 498-505
- Xu AXT, Brown K, Schwartz KL et al. Audit and Feedback Interventions for Antibiotic Prescribing in Primary Care: A Systematic Review and Meta-analysis. Clin Infect Dis 202580(2):253-262
C-Reactive Protein Point of care Testing and complementary strategies in children
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- Althaus T, Greer RC, Swe MMM, Cohen J, Tun NN, Heaton J, et al. Effect of point-of-care C-reactive protein testing on antibiotic prescription in febrile patients attending primary care in Thailand and Myanmar: an open-label, randomised, controlled trial. The Lancet Global health. 2019; 7(1):e119–e31.
- Burvenich R, Bos DAG, Lowie L et al. Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. British Journal of General Practice, February 2025
- Ciccone EJ et al. Point-of-care C-reactive protein measurement by community health workers safely reduces antimicrobial use among children with respiratory illness in rural Uganda: A stepped wedge cluster randomized trial. PLoS Med 202421(8):e1004416
- Ciccone EJ, Hu D, Preisser JS, Cassidy CA, Kabugho L, Emmanuel B, et al. Point-of-care C-reactive protein measurement by community health workers safely reduces antimicrobial use among children with respiratory illness in rural Uganda: A stepped wedge cluster randomized trial. PLoS Med 2024;21(8): e1004416.
- Covino M, Buonsenso D, Gatto A et al. Determinants of antibiotic prescriptions in a large cohort of children discharged from a pediatric emergency department. Eur J Pediatr 2022;181(5):2017-2030
- De Rop L, De Burghgraeve T, De Sutter A, Buntinx F, Verbakel JY. Point-of-care C-reactive protein test results in acute infections in children in primary care: an observational study. BMC Pediatrics 2022;22:633.
- Dewez JE, Nijman RG, Ftichett EJA et al. Adoption of C‑reactive protein point‑of‑care tests for the management of acute childhood infections in primary care in the Netherlands and England: a comparative health systems analysis. BMC Health Services Research 2023;23:191
- Dillen H, Wouters J, Snijders D, Wynants L, Verbakel JY. Factors associated with inappropriateness of antibiotic prescriptions for acutely ill children presenting to ambulatory care in high-income countries: a systematic review and meta-analysis. J Antimicrob Chemother 202479:498–511
- Do NT, Ta NT, Tran NT, et al. Point-of-care C-reactive protein testing to reduce inappropriate use of antibiotics for non-severe acute respiratory infections in Vietnamese primary health care: a randomised controlled trial. Lancet Glob Health 2016;4:e633–41.
- Do NTT, Vu TVD, Greer RC et al. Implementation of point-of-care testing of C-reactive protein concentrations to improve antibiotic targeting in respiratory illness in Vietnamese primary care: a pragmatic cluster-randomised controlled trial. Lancet Infect Dis 2023
- García-Sangenís A, Lykkegaard J, Hansen MP et al. Impact of a multifaceted intervention programme on antibiotic prescribing and dispensing in four patient-centred settings in five European countries. The HAPPY PATIENT project. Family Practice 202542:cmae064
- Hernández-Bou S, Trenchs V, Vanegas MI, Valls AF, Luaces C. Evaluation of the bedside Quikread go® CRP test in the management of febrile infants at the emergency department. Eur J Clin Microbiol Infect Dis 2017;36:1205-11.
- Isaeva E, Akylbekov A, Bloch J et al. The Feasibility of C-Reactive Protein Point-of-Care Testing to Reduce Overuse of Antibiotics in Children with Acute Respiratory Tract Infections in Rural Kyrgyzstan: A Pilot Study. Pediatric Health, Medicine and Therapeutics 2024:15 67–76
- Isaeva E, Bloch J, Akylbekovet A al. C-reactive protein testing in primary care and antibiotic use in children with acute respiratory tract infections in Kyrgyzstan: an open-label, individually randomised, controlled trial. The Lancet Regional Health – Europe 202551: 101184
- Keitel K, Samaka J, Masimba J, Temba H, Said Z, Kagoro F, et al. Safety and Efficacy of C-reactive Protein-guided Antibiotic Use to Treat Acute Respiratory Infections in Tanzanian Children: A Planned Subgroup Analysis of a Randomized Controlled Noninferiority Trial Evaluating a Novel Electronic Clinical Decision Algorithm (ePOCT). Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2019; 69(11):1926–34.
- Likopa Z, Kivite‑Urtane A, Silina V, Pavare J. Impact of educational training and C‑reactive protein point‑of‑care testing on antibiotic prescribing in rural and urban family physician practices in Latvia: a randomised controlled intervention study. BMC Pediatrics 20221.30277777777778
- Likopa Z, Kivite‑Urtane A, Silina V, Pavareet J. Impact of educational training and C-reactive protein point-of-care testing on antibiotic prescribing in rural and urban family physician practices in Latvia: a randomised controlled intervention study. BMC Pediatrics 2022;22:556
- Likopa Z, Kivite-Urtane A, Strele I, Pavare J. Effect of Combination of Point-of-Care C-Reactive Protein Testing and General Practitioner Education and Long-Term Effect of Education on Reducing Antibiotic Prescribing for Children Presenting with Acute Infections in General Practice in Latvia: A Randomized Controlled Intervention Study. Antibiotics 2024, 13, 867
- Marcus N, Mor M, Amir L, et al. The quick-read C-reactive protein test for the prediction of bacterial gastroenteritis in the pediatric emergency department. Pediatr Emerg Care. 2007;23:634–637.
- Nijman RG et al. C-Reactive Protein Bedside Testing in Febrile Children Lowers Length of Stay at the Emergency Department. Pediatr Emer Care 2015;31(9):633-9.
- Nijman RG et al. Validation of the Feverkidstool and procalcitonin for detecting serious bacterial infections in febrile children. Pediatric Research 2018;83(2):466-476.
- Schot MJC, Van den Bruel A, Broekhuizen BDL, Cals JWL, Noteboom EA, Balemans W, et al. Point-of-care C-reactive protein to assist in primary care management of children with suspected non-serious lower respiratory tract infection: A randomised controlled trial. BJGP Open. 2018; 2(3).
- Staiano A, Bjerrum L, Llor C, Melbye H, Hopstaken R, Gentile I, Plate A, van Hecke O and Verbakel JY. C-reactive protein point-of-care testing and complementary strategies to improve antibiotic stewardship in children with acute respiratory infections in primary care. Front Pediatr 2023; 11:1221007
- Van Hecke O, Raymond M, Lee JJ, Turner P, Goyder CR, Verbakel J, Van den Bruel A, Hayward G. In-vitro diagnostic point-of-care tests in paediatric ambulatory care: A systematic review and meta-analysis. PLoS ONE 2020; 15(7): e0235605.
- Verbakel JY et al. Erratum to: Should all acutely ill children in primary care be tested with point-of-care CRP: a cluster randomised trial. BMC Medicine 2017; 15:93.
- Verbakel JY et al. Point-of-care C reactive protein to identify serious infection in acutely ill children presenting to hospital: prospective cohort study. Arch Dis Child 2018; 103(5):420-426.
- Verbakel JY et al. Should all acutely ill children in primary care be tested with point-of-care CRP: a cluster randomised trial. BMC Medicine 2016;14:131.
C-Reactive Protein Point of care Testing: Meta-Analysis / Reviews
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- Aabenhus R, Jensen JUS, Jørgensen KJ, Hróbjartsson A, Bjerrum L. Biomarkers as point-of-care tests to guide prescription of antibiotics in patients with acute respiratory infections in primary care (Review). Cochrane Database of Systematic Reviews 2014, Issue 11.
- Boon HA, Struyf T, Bullens D et al. Diagnostic value of biomarkers for paediatric urinary tract infections in primary care: systematic review and meta-analysis. BMC Fam Pract 2021; 22:193
- Cooke J, Llor C, Hopstaken R, Dryden M, Butler C et al. Respiratory tract infections (RTIs) in primary care: narrative review of C reactive protein (CRP) point-of-care testing (POCT) and antibacterial use in patients who present with symptoms of RTI. BMJ Open Resp Res 2020;7:e000624.
- Ebell MH, Bentivegna M, Cai X, Hulme C, Kearney M. Accuracy of Biomarkers for the Diagnosis of Adult Community-acquired Pneumonia: A Meta-analysis. Acad Emerg Med. 2020 Mar;27(3):195-206.
- Fermont JM, Masconi KL, Jensen MT, Ferrari R, Di Lorenzo VAP, Marott JM, Schuetz P, Watz H, Waschki B, Müllerova H, Polkey MI, Wilkinson IB, Wood AM. Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis. Thorax. 2019 May;74(5):439-446.
- Hoste ME, Borek AJ, Santillo M et al. Point-of-care tests to manage acute respiratory tract infections in primary care: a systematic review and qualitative synthesis of healthcare professional and patient views. J Antimicrob Chemother 2024
- Hoult G, Gillespie D, Wilkinson TMA et al. Biomarkers to guide the use of antibiotics for acute exacerbations of COPD (AECOPD): a systematic review and meta-analysis. BMC Pulmonary Medicine 2022;22:194
- Martínez-González NA, Keizer E, Plate A et al. Point-of-Care C-Reactive Protein Testing to Reduce Antibiotic Prescribing for Respiratory Tract Infections in Primary Care: Systematic Review and Meta-Analysis of Randomised Controlled Trials. Antibiotics 2020;9(9):610. DOI: 10.3390/antibiotics9090610
- NICE [B] Evidence review for rapid tests to inform triage and antibiotic prescribing decisions. October 2023
- O’Brien K, Gloeckner L, Jordan K et al. EUnetHTA report 2019. Rapid assessment on other health technologies using the HTA Core Model for Rapid Relative Effectiveness Assessment. C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs). EUnetHTA Project ID: OTCA012.
- Olliaro P, Nkeramahame J, Horgan P et al. Synthesis and Meta-analysis of 3 Randomized Trials Conducted in Burkina Faso, Ghana, and Uganda Comparing the Effects of Point-of-Care Tests and Diagnostic Algorithms Versus Routine Care on Antibiotic Prescriptions and Clinical Outcomes in Ambulatory Patients <18 Years of Age With Acute Febrile Illness. CID 2023;77 (2): S199
- Smedemark SA, Aabenhus R, Llor C, Fournaise A, Olsen O, Jørgensen KJ. Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care. Cochrane Database Syst Rev 2022;10(10):CD010130
- Tonkin-Crine SKG, Tan PS, van Hecke O, Wang K, Roberts NW, McCullough A, Hansen MP, Butler CC, Del Mar CB. Clinician-targeted interventions to influence antibiotic prescribing behaviour for acute respiratory infections in primary care: an overview of systematic reviews. Cochrane Database of Systematic Reviews 2017; Issue 9. Art. No.: CD012252.
- Verbakel JY, Lee JJ, Goyder C et al. Impact of point-of-care C reactive protein in ambulatory care: a systematic review and meta-analysis. BMJ Open 2019;9:e025036. doi:10.1136/bmjopen-2018-025036
- Zhang K, Xie K, Zhang C et al. C-reactive protein testing to reduce antibiotic prescribing for acute respiratory infections in adults: a systematic review and meta-analysis. J Thorac Dis 2022;14(1):123-13
Guidelines related to C-Reactive Protein Point of care Testing
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- Belgium: Belgian Antibiotic Policy Coordination Commission (BAPCOC). Belgische gids voor anti-infectieuze behandeling in de ambulante praktijk. November 2022.
- Denmark: Dansk Selskab for Almen Medicin. Akutte luftvejsinfektioner og rationel antibiotikabehandling i almen praksis
- Europe: Euro. Resp. Guideline of ERS and ESCMID: Woodhead et al. Guidelines for the management of adult lower respiratory tract infections. Clin Micro Inf 2011; 17(6): 1-24.
- Germany: Krüger K et al. Akuter und Chronischer Husten; S3-Leitlinie; DEGAM-Leitlinie Nr. 11. AWMF-Register-Nr. 053-013; 2021.
- Netherlands: De Bont EGPM, Greving JP, Kurver MJ et al. NHG-Standaard. Acuut hoesten (M78). Versie 2.1, februari 2024
- Norway: Helsedirektoratet. Antibiotika i primærhelsetjenesten: Nasjonal faglig retningslinje.
- South Africa: Boyles TH et al. South African guideline for the management of community acquired pneumonia in adults Journal of thoracic disease 2017; 9(6).
- Spain: Guía de Terapéutica Antimicrobiana del Área Aljarafe, 3ª edición. 2016-2018.
- Spain: GUÍA DE USO DE ANTIMICROBIANOS EN TRATAMIENTOS AMBULATORIOS. ADULTOS (3ª edición). Madrid: Consejería de Sanidad, Servicio Madrileño de Salud; septiembre 2023.
- Spain: Llor C, Moragas A. In: Patología infecciosa. (eds.) Martín Zurro A, Cano Pérez JF, Gené Badia J, Atención Primaria, Principios, organización y métodos en Medicina de Familia, Barcelona: Elsevier España 2024: 856–892.
- Spain: Programa de Optimización de Tratamiento Antibiótico de Castilla y León (PROACYL). Tecnicas de diagnostico rápido en atención primaria (TDR): determinación de la proteína C reactiva (PCR); adultos y niños. 2021.
- Sweden: Behandlingsrekommendationer för vanliga infektioner i öppenvård 2023
- Switzerland: Medix. Guideline COPD. 2017. Last update 2019.
- United Kingdom: NICE guideline [NG237]. Suspected acute respiratory infection in over 16s: assessment at first presentation and initial management. Last updated: 02 November 2023.
- United Kingdom: Respiratory Health Implementation Group. The All Wales Primary Care Management of Acute COPD Exacerbation Guideline. 2020.
- United Kingdom: The Primary Care Respiratory Society. The place of point of care testing for C-reactive protein in the community care of respiratory tract infections. Issue 24 Summer 2022.
Cost-effectiveness of C-Reactive Protein Point of care Testing
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- Boere TM, El Alili M, van Buul LW, et al. Cost-effectiveness and return-on-investment of C-reactive protein point-of-care testing in comparison with usual care to reduce antibiotic prescribing for lower respiratory tract infections in nursing homes: a cluster randomised trial. BMJ Open 2022;12:e055234.
- Cals JWL, Ament HA, Hood K, Butler CC, Hopstaken RM, Wassink GF, Dinant GJ. C-reactive protein point of care testing and physician communication skills training for lower respiratory tract infections in general practice: economic evaluation of a cluster randomized trial. Journal of Evaluation in Clinical Practice 2011; 17: 1059–1069.
- D’hulster E, De Burghgraeve T, Luyten J, Verbakel J. Cost-effectiveness of point-of-care interventions to tackle inappropriate prescribing of antibiotics in high- and middle-income countries: a systematic review. J Antimicrob Chemother 2022.
- Francis NA, Gillespie D, White P et al. C-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT. Health Technol Assess 2020; 24: 1–108.
- Health Information and Quality Authority Ireland. Health Technology Assessment of C-reactive protein point-of-care testing to guide antibiotic prescribing for acute respiratory tract infections in primary care settings; 2019.
- Holmes, Emily AF, et al. Cost-effectiveness analysis of the use of point-of-care C-reactive protein testing to reduce antibiotic prescribing in primary care. Antibiotics 2018; 7, 106.
- Hunter, R. Cost-Effectiveness of Point-of-Care C-Reactive Protein Tests for Respiratory Tract Infection in Primary Care in England, Adv Ther 2015; 32, 69–85.
- Lubell Y, Do NTT, Nguyen KV et al. C-reactive protein point-of-care testing in the management of acute respiratory infections in the Vietnamese primary healthcare setting – a cost benefit analysis. Antimicrob Resist Infect Control 2018; 7: 119.
- Oppong R, Smith RD, Little P, Verheij T, Butler CC, Goossens H, Coenen S, Moore M, Coast J. Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care: an economic evaluation accounting for the cost of antimicrobial resistance. Br J Gen Pract 2016 Sep;66(650):e633-9.
- Ruiz R, Moraga A, Trapero-Bertram M et al. Effectiveness and cost-effectiveness of Improving clinicians’ diagnostic and communication Skills on Antibiotic prescribing Appropriateness in patients with acute Cough in primary care in CATalonia (the ISAAC-CAT study): study protocol for a cluster randomized controlled trial. Trials 2019; 20:740.
- Schneider JE, Boehme C, Borisch B, Dittrich S. Application of a simple point-of-care test to reduce UK healthcare costs and adverse events in outpatient acute respiratory infections. Journal of Medical Economics 2020; 23(7):673–682
- Shrestha P, Cooper BS, Coast J, Oppong R, Do Thi Thuy N, Phodha T, Celhay O, Guerin PJ, Wertheim H, Lubell Y. Enumerating the economic cost of antimicrobial resistance per antibiotic consumed to inform the evaluation of interventions affecting their use. Antimicrob Resist Infect Control. 2018 Aug 9;7:98.
- Tolley A, Bansal A, Murerwa R, Dicks JH. Cost-effectiveness of point-of-care diagnostics for AMR: a systematic review. J Antimicrob Chemother 2024 79: 1248–1269
- Van der Pol S, Jansen DEMC, van der Velden AW et al. The Opportunity of Point‑of‑Care Diagnostics in General Practice: Modelling the Effects on Antimicrobial Resistance. PharmacoEconomics 202240:823–833:
- Van Dorst PWM, van der Pol S, Olliaro P et al. Cost Effectiveness of Test and Treat Strategies to Reduce the Antibiotic Prescription Rate for Acute Febrile Illness in Primary Healthcare Clinics in Africa. Applied Health Economics and Health Policy 2024;22:701–715
- Wong HY, Marcu LG, Bezak E, Parange NA. Review of Health Economics of Point-of-Care Testing Worldwide and Its Efficacy of Implementation in the Primary Health Care Setting in Remote Australia. Risk Management and Healthcare Policy 202013:379–386
- Wubishet BL, Merlo G, Ghahreman-Falconer N et al. Economic evaluation of antimicrobial stewardship in primary care: a systematic review and quality assessment. J Antimicrob Chemother 2022; 77: 2373–2388.
Antimicrobial Resistance
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- Anderson M, Panteli D, Mossialos E. Strengthening the EU response to prevention and control of Antimicrobial Resistance (AMR): Policy priorities for effective implementation. Copenhagen: WHO Regional Office for Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO. ISBN: 1997-8073
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Physician-patient consultations are crucial for effective communication. Research indicates that combining CRP POCT with communication training for physicians significantly reduces antibiotic prescribing.
Key messages for communication of physicians with patients can be found in these publications:
HAPPY PATIENT (Health Alliance for Prudent Prescription and Yield of Antibiotics from a Patient-Centered Perspective) is an initiative funded by the European Union, which aims to reduce antimicrobial resistance by decreasing inappropriate antibiotic use.
HAPPY PATIENT has developed informative materials for healthcare professionals and patients to help make informed decisions about antibiotic use.