Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group.
Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group.
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DOI：
10.1186/1471-2296-15-80
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发表时间：
2014-05-02
影响因子：
2.9
通讯作者：
Melbye H
中科院分区：
文献类型：
--
作者：
Andreeva E;Melbye H
C反应蛋白（CRP）的即时检测已显示出作为减少呼吸道感染（RTI）中不必要的抗生素处方的措施的前景，但其在初级保健中的使用仍存在争议。我们的目的是评估CRP检测对抗生素处方、转诊放射学检查以及全科急性咳嗽/RTI患者结局的影响。进行了一项开放群随机临床试验，并在干预组中进行了C反应蛋白检测。抗生素处方和转诊放射学检查是主要的结局指标。共纳入179例患者：干预组101例，对照组78例。两组的临床特征相似。干预组抗生素使用率为37.6%，明显低于对照组的58.9%（P = 0.006）。干预组的胸部X线转诊率（55.4%）也显著低于对照组（75.6%）（P = 0.004）。全科医生记录的恢复率在干预组和对照组分别为92.9%和93.6%。该研究表明，急性咳嗽/RTI患者的CRP检测可能会减少抗生素处方和转诊放射学检查，可能不会影响恢复。试验在ClinicalTrials.gov方案注册系统中注册（识别号：NCT 01794819）。
Point of care testing for C-reactive protein (CRP) has shown promise as a measure to reduce unnecessary antibiotic prescribing in respiratory tract infections (RTI), but its use in primary care is still controversial. We aimed to evaluate the effect of CRP testing on the prescription of antibiotics, referral for radiography, and the outcome of patients in general practice with acute cough/RTI. An open-cluster randomized clinical trial was conducted, with CRP testing performed in the intervention group. Antibiotic prescribing and referral for radiography were the main outcome measures. A total of 179 patients were included: 101 in the intervention group and 78 in the control group. The two groups were similar in clinical characteristics. In the intervention group, the antibiotic prescribing rate was 37.6%, which was significantly lower than that in the control group (58.9%) (P = 0.006). Referral for chest X-ray was also significantly lower in the intervention group (55.4%) than in the control group (75.6%) (P = 0.004). The recovery rate, as recorded by the GPs, was 92.9% and 93.6% in the intervention and control groups, respectively. The study showed that CRP testing in patients with acute cough/RTI may reduce antibiotic prescribing and referral for radiography, probably without compromising recovery. The trial was registered in the ClinicalTrials.gov Protocol Registration System (identification number: NCT01794819).
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抗生素处方的变化及其对初级保健急性咳嗽患者恢复的影响：13个国家的前瞻性研究。
DOI：
10.1136/bmj.b2242
发表时间：
2009-06-23
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Butler CC;Hood K;Verheij T;Little P;Melbye H;Nuttall J;Kelly MJ;Mölstad S;Godycki-Cwirko M;Almirall J;Torres A;Gillespie D;Rautakorpi U;Coenen S;Goossens H
通讯作者：
Goossens H
影响因子：
2.1
作者：
MELBYE H;STRAUME B;BROX J
通讯作者：
BROX J
影响因子：
2.1
作者：
Jakobsen, Kristin Alise;Melbye, Hasse;Butler, Christopher C.
通讯作者：
Butler, Christopher C.
影响因子：
2
作者：
Carter, Ben
通讯作者：
Carter, Ben
影响因子：
3.4
作者：
Coenen, Samuel
通讯作者：
Coenen, Samuel