Impact of the Use of CRP on the Prescription of Antibiotics in General Practitioners (VIP)

Centre Hospitalier Intercommunal Creteil

Status: Completed

Conditions: Respiratory Infections in Children; Respiratory Infection

Treatments: Diagnostic Test: Care with C-reactive protein assay in micro method

Study type: Interventional

Funder types: Other

Identifiers

NCT03540706

AOR17072 (Other Grant/Funding Number)

VIP

2018-A00242-53 (Other Identifier)

Details and patient eligibility

About

Respiratory infections, including episodes of coughing with fever, are the main cause of outpatient antibiotic prescription, while a minority of them are linked to bacterial infections requiring antibiotic. These prescriptions are often performed by general practitioners. These unnecessary antibiotic contribute to increased bacterial resistance, side effects and unnecessary costs. Campaigns for the correct prescription of antibiotics have had a real but partial or transient success.

C-reactive protein micro-method (POCT-CRP) could help to differentiate between viral and bacterial infections and thus contribute to the proper use of antibiotics. The decrease in prescription of antibiotics is likely to have an even stronger positive impact in countries like France, where prescription is high.

The objective of this study is to evaluate the use of POCT-CRP in the general practitioner's office in case of suspected respiratory infection.

Enrollment: 406 patients

Sex: All

Ages: 3+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥ 3 years
• Clinical suspicion of respiratory infection defined by the presence of at least one respiratory sign among, cough, dyspnea, chest pain and auscultatory abnormality and at least one general sign among fever, sweat, headache, myalgia, impairment of general condition
• Affiliated to a social health insurance
• Signed consent

Exclusion criteria

• Duration of symptoms < 24 hours
• Hospitalization or emergency assessment decision decided from the outset
• Signs of severity before the realization of POCT-CRP
• Patient previously included in the study for the same episode
• Antibiotic therapy within 7 days
• Chronic cough (more than 3 weeks)

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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406 participants in 2 patient groups

Care with C-reactive protein assay in micro method

Experimental group

Description:

During a visit to the general practitioner for a clinical suspicion of respiratory infection, the doctor will practice a C-reactive protein assay in micro method. He will prescribe antibiotics according to the result of the dosage

Treatment:

Diagnostic Test: Care with C-reactive protein assay in micro method

Care without C-reactive protein assay in micro method

No Intervention group

Description:

Simple management of a patient coming for a suspicion of respiratory infection without dosage of the C-reactive protein in micro method