Use of a rapid C-reactive protein (CRP) blood test in general practice for people with a flare-up of COPD reduces the proportion who take antibiotics over the next month by about 20 percentage points compared with usual care alone. The reduction in antibiotic use does not lead to worse health, more visits to the doctor or greater need for antibiotics later on.
Flare-ups of COPD can be caused by infections of the airways or environmental triggers, and cause about 115,000 admissions to hospital every year. Determining whether a flare-up is due to infection is difficult in primary care, and antibiotics are often prescribed to treat a presumed underlying bacterial infection.
This NIHR-funded trial provides strong evidence that a rapid test for raised CRP levels, which occur with serious infection, could help prescribers in primary care make better decisions about who needs antibiotics to treat a flare-up of COPD and who doesn’t.
The study was conducted by Professor Chris Butler, Director of the Community Healthcare MIC, with colleagues from several UK universities.