scholarly journals An intervention with access to C-reactive protein rapid test reduces antibiotic overprescribing in acute exacerbations of chronic bronchitis and COPD

2015 ◽  
pp. cmv020 ◽  
Author(s):  
David F Strykowski ◽  
Anni B S Nielsen ◽  
Carl Llor ◽  
Volkert Siersma ◽  
Lars Bjerrum
CHEST Journal ◽  
2010 ◽  
Vol 138 (5) ◽  
pp. 1108-1115 ◽  
Author(s):  
Johannes M.A. Daniels ◽  
Marianne Schoorl ◽  
Dominic Snijders ◽  
Dirk L. Knol ◽  
René Lutter ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Wen Song ◽  
Yue Wang ◽  
Fengming Tian ◽  
Liang Ge ◽  
Xiaoqian Shang ◽  
...  

Background. Currently, standards of antibiotic use in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients are controversial. Objective. The aim of the present study was to analyze the value of procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) levels to guide the antibiotic treatment of AECOPD patients. Methods. A total of 371 patients with COPD or AECOPD were included in the study. Clinical and laboratory data were obtained at admission, 325 AECOPD patients and 46 sCOPD patients treated with antibiotics. The receiver operating curve (ROC) was used to evaluate the relationship between CRP, PCT, and IL-6. Results. This study included medical record/case control 1, the COPD group ( n = 46 ) and the AECOPD group ( n = 325 ), and medical record control 2, the nonchanged antibiotic group ( n = 203 ) and the changed antibiotic group ( n = 61 ). In case 1, CRP, PCT, and IL-6 levels in the AECOPD group were higher than that in the control group ( P < 0.05 ), while the result of ROC showed that IL-6 had higher AUC values (0.773) and higher sensitivity (71.7%) than other indicators. The specificity of PCT (93.5%) is higher than other indicators. In case 2, ROC curve results showed that the AUC value of IL-6 (0.771) was slightly higher than PCT and CRP. The sensitivity (85.2%) and specificity (65.5%) of CRP were higher than other indicators. Conclusions. IL-6 and PCT were elevated in AECOPD patients, resulting in a higher diagnostic value for AECOPD. CRP had a higher diagnostic value for antibiotic use in AECOPD patients.


Author(s):  
Susanna Esposito ◽  
Elena Tremolati ◽  
Enrica Begliatti ◽  
Samantha Bosis ◽  
Laura Gualtieri ◽  
...  

AbstractRegardless of its origin, any condition associated with inflammation is accompanied by an increase in serum C-reactive protein levels. This study compared the results of a rapid test for the bedside assay of C-reactive protein (QuikRead CRP, Orion Corporation, Orion Diagnostica, Espoo, Finland) with those of a standard laboratory assay in samples taken from 231 children aged less than 14years (126 males; median age 4.7years) attending the Emergency Department of Milan University's Institute of Pediatrics because of acute respiratory infection. The two methods showed similar median C-reactive protein levels (standard laboratory assay: 34.7mg/L, range 4–199mg/L; QuikRead CRP: 33.3mg/L, range <8–196mg/L; p=0.779) and a similar distribution of children with C-reactive protein levels of <20mg/L, 20–70mg/L and >70mg/L. This study shows for the first time that the rapid QuikRead CRP test can be performed at the bedside or in an outpatient clinic and, in less than 5min, gives the same quantitative results as those obtained using a more complex routine laboratory method.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S315-S315
Author(s):  
M Takacs ◽  
A Hellige ◽  
T Schuster ◽  
S Schleifenbaum ◽  
D Föll ◽  
...  

Abstract Background Only few biomarkers are useful for the therapy monitoring of patients suffering from inflammatory diseases, like inflammatory bowel disease (IBD) or rheumatoid arthritis (RA). Next to calprotectin C-Reactive Protein (CRP) is the best described and usually measured in the central laboratory. However, most patients are regularly checked at GP’s offices or small ambulatories. These sites need fast results with simple technology to react immediately. Our quantitative CRP rapid test based on lateral flow technology combined with a cost-effective reader fulfils all these criteria. It can be used with serum and whole blood. Here, we report the validation of the Quantum Blue® hsCRP in capillary blood and show first clinical applications of this new test. Methods The sandwich-type lateral flow test employing anti-CRP antibody-coated gold nanoparticles was calibrated with the ERM-DA474 CRP reference material. Fingerprick blood was collected and diluted 1:10 with a dedicated capillary blood preparation set and then applied onto the test cassette. After a 15-min incubation, the readout was performed with the Quantum Blue® Reader resulting in a quantitative measuring range of 1 to 20 mg/l. 122 capillary blood/serum pairs were collected to compare this rapid hsCRP test with the fully automated serum CRPL3 (PETIA) test on Roche cobas® c501. Clinical performance data together with concomitant CRP measurements were collated from 20 IBD and 69 RA patients. The resulting capillary blood CRP values including those from 28 healthy subjects were used to establish preliminary clinical cut-off values. Results 56 capillary blood/serum sample pairs with values within the measuring range of both the hsCRP and the CRPL3 PETIA could be elected for a quantitative comparison. The capillary blood values were corrected against a mean haematocrit of 42%. A strong correlation (R = 0.941) with a minor bias of 6.1% by Bland-Altman plot was observed. Non-parametric analyses of capillary blood CRP levels from 20 IBD and 69 RA patients vs. their disease activity scores (CDAI, Mayo, DAS28, active joints) resulted in an upper reference limit of 5.8 mg/l and a 95%ile reference range from 1.0 to 19.7 mg/l. Patients with moderate (IBD) to severe (IBD, RA) disease activity could be significantly discriminated by capillary blood CRP from those with low activity or remission. Conclusion The BÜHLMANN Quantum Blue® hsCRP rapid test allows fast and easy detection of CRP in human capillary blood within 15 min in ambulatory settings. The assay shows an excellent absolute correlation to a fully automated serum CRP reference method. A preliminary clinical cut-off of 5.8 mg/l was established in two cohorts of IBD and RA patients to discriminate high from low disease activity.


2021 ◽  
Vol 121 (1) ◽  
pp. 51-64
Author(s):  
Liudmyla Gospodarenko ◽  
Tetiana Klets ◽  
Ganna Gnyloskurenko ◽  
Roman Terletskyi ◽  
Diana Kononenko

Rapid diagnosis significantly reduces the patient's expectation of effective medical care. As a result, rapid or POC-tests are becoming increasingly important in the world. However, the frequency of their use, the availability of tests in medical facilities, the awareness of physicians about diagnostic capabilities and the need for them are currently unclear. The aim of our study was to determine the level of awareness of physicians about the use of rapid tests for influenza, RS-virus, ꞵ-hemolytic group A streptococcus  and laboratory markers of inflammation in the form of POC-tests in daily practice. The study was conducted by interviewing 78 pediatricians and family physicians in Kyiv and Kyiv region who work at the primary and secondary levels of medical care. A questionnaire from EAPRASnetT (European Academy of Pediatric Research in the network of outpatient settings) was used for the survey. Our research has shown that hospital physicians are more informed about the use of rapid diagnostics and are more willing to use it in the treatment and diagnostic process. A rapid antigen test for influenza is available to the vast majority of inpatients (78%) and only half of outpatients (46.3%). Half of primary care physicians (56.1%) and the vast majority of secondary care professionals (73%) are willing to use this test in practice if it is available. The results of our study also showed a higher adherence to this rapid test of inpatients, as only 2.7% of them would like to confirm the results of POC-tests by laboratory tests (compared to 22% of outpatients). Most doctors in both outpatient clinics (61%) and inpatients (75.7%) are ready to use a rapid test for respiratory syncytial virus. Only 2.7% of hospital doctors would like to have a laboratory version, and outpatients would be completely satisfied with a quick test. However, due to the lack of trust in 14.6% of cases, they would like to confirm its results by laboratory testing. About a third of physicians (39%) use the rapid test for ꞵ-hemolytic group A streptococcus in the outpatient clinic, but half (51.2%) stated the need for this test and its unavailability. In the hospital, the data obtained were the opposite: half of doctors already use this test (59.5%), and another third would like to have it (35.1%). Rapid C-reactive protein testing is poorly used by physicians in both health care settings (12.2% in the outpatient setting and 29.7% in the inpatient setting) due to low security and lack of awareness. This is confirmed by the fact that 75.6% of primary and 64.9% of secondary care physicians stated that the test is not available, but they are ready to use this test if available. POC-test for C-reactive protein is used more in the hospital than in the outpatient clinic. At the outpatient stage, 12.2% of physicians do not consider it appropriate to use C-reactive protein in the diagnosis of diseases, in the hospital of such physicians 5%. About 10% of doctors in both groups expressed distrust in the rapid CRP-test, as they would like to use only the laboratory version. Doubts about the accuracy of almost twice as many outpatients, as more often would like to check it with a laboratory version (19.5% vs. 10.8% of inpatients). Therefore, one in five physicians in the outpatient clinic would use both the laboratory and POC versions. The rapid test for procalcitonin is used by every 5th doctor in the hospital and only 7% of the primary care, which can be attributed to the low availability of the test in medical practice, poor provision of medical institutions with POC-tests, as 62.2% and 78% of doctors the hospital and the clinic replied that they would use it if it was available. As for the complete general analysis of blood with leukocyte formula, only 17.1% and 35.5% of doctors of the polyclinic and hospital would like to use its POC version. Interviewed physicians would prefer a laboratory version of the test.It is necessary to raise awareness of physicians, especially primary care, about modern diagnostic methods, namely the practice of POC-tests and make them more accessible, which would significantly improve the diagnosis and treatment of patients, would have a positive impact on public health and significant economic effect.


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