Implementing point-of-care CRP testing for better diagnosis of acute respiratory infections

INTRODUCTION

Many countries in Europe have routinely implemented the use of point-of-care testing (POCT) for c-reactive protein (CRP) in primary care to guide antibiotic therapy in patients with acute respiratory infections; however, this has not been implemented in the UK or Australia. General practice is where the majority of antibiotics are prescribed and CRP testing may provide a means to help limit antibiotic use to those patients with severe (bacterial) infections. A recent addition to this debate is whether the arguments to measure CRP rapidly also need to be applied to COVID-19 testing.

The clinical evidence to support CRP POCT to guide antibiotic therapy in adult patients was recently reviewed by Cals and Ebell. They concluded that in adults there is accumulating evidence that CRP use can help safely reduce antibiotic usage in patients with acute respiratory infections.¹ A recent narrative review by Cooke et al queried why the test is not more widely used in the UK.²

Given the extent of the evidence base, the issue becomes one of identifying the remaining barriers to implementation and how they can be addressed.