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NEJM reports on the utility of C-reactive protein (CRP) testing in chronic obstructive pulmonary disease (COPD) patients, showing that CRP guided prescribing of antibiotics for exacerbations of COPD in primary care clinics resulted in a lower percentage of patients who reported antibiotic use.
This multicenter, open-label, randomized, controlled trial involving COPD patients in England and Wales. Patients were randomized to usual care versus CRP point-of-care testing (CRP-guided group) in the assessment and management of acute exacerbations of COPD.
Of the 653 patients studied, fewer patients in the CRP-guided group reported antibiotic use than in the usual-care group (57.0% vs. 77.4%; adjusted odds ratio, 0.31; 95% confidence interval [CI], 0.20 to 0.47).
A lower percentage of patients in the CRP-guided group than in the usual-care group received an antibiotic prescription at the initial consultation (47.7% vs. 69.7%; OR 0.31) and during the first 4 weeks of follow-up (59.1% vs. 79.7%; OR 0.30).
CRP-guided prescribing of antibiotics for exacerbations of COPD in primary care clinics resulted in a lower percentage of patients who reported antibiotic use and with no evidence of harm.