Routine C-reactive protein testing in patients with acute cough and lower respiratory tract infections can reduce antibiotic use and is cost effective, concludes a new study.
Norwegian researchers recruited 370 primary care patients aged from 18 to 86 years who initially presented to their GP with cough, phlegm or feeling generally unwell. Patients completed EQ-5D questionnaires and symptom diaries while clinicians completed case report forms at the first visit. They were followed up for 28 days.
Patients with acute cough and LRTI who were CRP tested at the first visit had increased healthcare costs of €11.27 and a reduction in antibiotics prescribing by 10% per patient, compared with those who were not. CRP testing was associated with an additional reduction in antibiotic prescribing at the cost of €112.70 per patient prescription avoided as a result of testing, and a cost per QALY gain of €9391. The probability of CRP being cost-effective was approximately 70%, at a willingness-to-pay threshold of €30 000 per QALY.
What this means for GPs
The authors concluded: ‘CRP testing is likely to provide a cost-effective diagnostic intervention both in terms of reducing antibiotic prescribing and in terms of QALYs gained.’