Finger-prick test to reduce antibiotic use

A simple finger-prick blood test could help prevent unnecessary prescribing of antibiotics for people with the lung condition chronic obstructive pulmonary disease (COPD), according to a new study by researchers including Trinity College Professorial Fellow in Primary Healthcare Chris Butler.

With funding from the National Institute for Health Research, the team from Cardiff University, University of Oxford and King’s College London demonstrated that using a CRP finger-prick blood test resulted in 20% fewer people using antibiotics for COPD flare-ups. Importantly, this reduction in antibiotic use did not have a negative effect on patients’ recovery over the first two weeks after their consultation at their GP surgery, or on their well-being or use of health care services over the following six months.

Safely reducing the use of antibiotics in this way may help in the battle against antibiotic resistance. The finger-prick test measures the amount of C-reactive protein (CRP) – a marker of inflammation that rises rapidly in the blood in response to serious infections. People with a COPD flare-up who have a low CRP level in the blood appear to receive little benefit from antibiotic treatment.

Professor Butler said: ‘This rigorous clinical trial speaks directly to the pressing issues of; preserving the usefulness of our existing antibiotics; the potential of stratified, personalised care; the importance of contextually-appropriate evidence about point of care testing in reducing unnecessary antibiotic use, and; enhancing the quality of care for people with the common condition of chronic obstructive pulmonary disease.

‘Most antibiotics are prescribed in primary medical care, and many of these prescriptions do not benefit patients: point of care testing is being vigorously promoted as a critical solution for better targeted antibiotic prescribing. However, there have been virtually no trials of point of care tests that measure impact on clinician behaviour, patient behaviour and patient outcomes. Acute exacerbations of chronic pulmonary disease account for considerable proportion of unnecessary antibiotic use, but a good solution to the problem in ambulatory care (where most of the antibiotics are prescribed) has not been identified until now. Ours is the first trial of biomarker guided management of AECOPD in ambulatory care, and has found an effect that should be practice-changing.’

Posted: 11 July 2019

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