Acute respiratory infections (ARIs) are by far the most common reason for prescribing an antibiotic in primary care, even though the majority of ARIs are of viral or non-severe bacterial etiology.

Unnecessary antibiotic use will, in many cases, not be beneficial to the patients' recovery and expose them to potential side effects and as a causal link exists between antibiotic use and antibiotic resistance, reducing unnecessary antibiotic use is a key factor in controlling this important problem.

Danish scientists led by those at the University of Copenhagen (Denmark) assessed the benefits and harms of point-of-care biomarker tests of infection to guide antibiotic treatment in patients presenting with symptoms of acute respiratory infections in primary care settings regardless of age. They looked at evidence from randomized trials on use of the C-reactive protein test (CRP), which is currently the only on-the-spot kit available to general practitioners intended to guide antibiotic prescription.

The investigators examined data on the use of the test was available from six trials involving a total of 3,284 predominantly adult patients. Overall, 631 out of the 1,685 people who took the biomarker test were prescribed antibiotics, compared to 785 out of the 1,599 people who did not take the test. Antibiotic use was 22% lower in the group who took the test. The review found no difference between the two groups in terms of how long patients took to recover. Some of the kits used for CRP were from Axis Shield (Oslo, Norway).

The scientists concluded that the test seems to be safe in its current form. However, in one of the six trials, based on a small number of cases, those who took the biomarker test were more likely to be admitted to hospital at a later date. Rune Aabenhus, MD, who is based at the Department of Public Health in Copenhagen said, “These results suggest that antibiotic use in patients with acute respiratory infections could be reduced by carrying out biomarker tests in addition to routine examinations. Going forward, it would be useful to see more evidence on the size of the reduction and cost-savings, as well as how these tests compare to other antibiotic-saving approaches.” The study was published on November 6, 2014, in the Cochrane Library.

Related Links:
University of Copenhagen 
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