Reduce antibiotic use with point-of-care testing

Antibiotics are among the most valuable classes of drugs ever discovered. They save countless lives every year, but due to rampant worldwide overuse there is a danger of losing this essential medical resource soon. Antimicrobial resistance is a serious healthcare and economic problem affecting the efficacy of antibiotics. Point-of-care testing (POCT) of C-reactive protein (CRP) may reduce the unnecessary use of antibiotics so they remain effective for generations to come.

With 30 years of experience, Abbott continues to offer leading solutions in CRP POCT. Having launched its first quantitative CRP visual test in 1989, the company is now supplying one of the best-in-class fully automated CRP tests in the marketplace. The Afinion CRP not only saves the time of both healthcare professionals (HCPs) and their patients, but has also been shown to reduce antibiotic prescribing by more than 60% if combined with communication training for general practitioners.

When it comes to diagnosis and treatment, it is crucial to identify those patients with a severe bacterial infection who need to start antibiotic therapy as soon as possible while also avoiding unnecessary antibiotic prescriptions. CRP is a major acute-phase biomarker, which can be used to differentiate self-limiting viral infections from severe bacterial infections and help HCPs identify patients with respiratory tract infections (RTIs) who would benefit from antibiotics, and those who would not.

CRP testing can therefore help HCPs make the right decision for their patients and simultaneously improve antimicrobial stewardship.

Tried and tested

The New England Journal of Medicine recently published the results of a UK-based multicentre study about the use of CRP POCT using the Afinion CRP in patients presenting with acute exacerbation of chronic obstructive pulmonary disease (COPD) in 86 general practices in England and Wales. In this study, the authors performed an openlabel randomised controlled trial involving patients with a diagnosis of COPD to determine whether POCT of CRP would reduce antibiotic prescribing.

Their findings suggested that guided antibiotic prescribing for exacerbations of COPD using CRP POCT resulted in a lower percentage of patients who reported antibiotic use and who received antibiotic prescriptions from clinicians. A 20.4% absolute reduction in antibiotic prescribing (57.0% versus 77.4%) during the first four weeks of follow-up was identified compared with usual care, without any negative effect on patient outcomes or on reconsultation rates.

The European Network for Health Technology Assessment (EUnetHTA), a collaborative network established for health technology assessment across Europe, assessed the relative effectiveness and safety of CRP POCT to guide antibiotic prescribing in patients with acute RTIs in primary care settings.

From 12 included studies, the survey concluded that CRP POCT may be used in the treatment of patients who present with symptoms of acute RTI, resulting in reduced antibiotic prescribing both at index consultation and up to 28 days follow-up without compromising patient safety. All studies in the report had been performed with quantitative CRP POCT.

The authors also assessed the accuracy of CE-marked devices in Europe. In those studies that compared the Afinion CRP with other methods, the Afinion CRP was reported to be easy to use and was one of the methods with the lowest systematic bias, scoring well in quality assurance schemes. The survey concluded that devices that are easier to use tend to have less pre-analytical handling and are less susceptible to human error.

In addition to offering easy, on-thespot testing with accurate results in just three minutes, the Afinion CRP can guide decision-making about antibiotics during consultation and allow for the immediate prescription of these drugs when required. The efficiencies achieved in the use and effectiveness of antibiotics are dramatic. On average, antibiotic prescriptions are reduced by up to 42% and, as previously mentioned, over 60% if the use of Afinion CRP is combined with communications training for general practitioners. The Afinion CRP is part of Abbott’s commitment to make every minute count, and keep antibiotics working for future generations.