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C-reactive protein tests: part of the solution against inappropriate antibiotic prescribing?

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Recently, the national media have highlighted a three-minute blood test that could tell GPs whether an antibiotic is needed for a patient. It has even been claimed that this test could tackle the ongoing issue of antibiotics resistance since it may put patients — who otherwise pressure GPs into prescribing an antibiotic — at ease. 

The test involves taking a drop of blood from the finger and can reveal within three minutes whether an illness is bacterial or viral. C-reactive protein, a marker of inflammation, is more elevated if an infection is bacterial — and less so if the infection is viral.

Currently, the test is available only in laboratories in the UK because the NHS does not fund its use in GP practices. The machine to analyse the test costs £1,000 and it costs £3 to do a test.

So, what about the idea of community pharmacists offering this test to patients?

Sid Dajani, Royal Pharmaceutical Society Treasurer and English Pharmacy Board member, said it is likely to be some time before the test is routinely available on the NHS. He said: “CRP testing would be a natural extension to the clinical services [pharmacists] offer, but it will be two or three years before there is enough evidence for it to be made widely available.”

There are, however, concerns about the test as well. Test results may not always be clear, and levels of CRP also increase because of inflammation caused by other conditions. Therefore, patients’ other symptoms and existing medical conditions will need to be taken into account.

Mr Dajani emphasised that, to see this test as a panacea is dangerous. It is important to educate patients when it is appropriate to take antibiotics and make sure they take them correctly and finish the course.

CRP testing is already widely used in northern Europe to help differentiate between bacterial and viral infections in primary care. Perhaps the UK might follow suit in a few years. I do not think that CRP testing is the ultimate solution to the problem of antibiotics resistance. Educating both prescribers and patients is a better option. On a global scale, there needs to be uniform regulation of distribution of antibiotics. These are not ordinary items of commerce that should be available for purchase from any shop (eg, in some countries in Asia). They should only be prescribed appropriately by trained healthcare professionals.

 

 

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