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Fever is the leading reason for outpatient consultations among children aged 2 to 9 years. The main concern in fever is severe bacterial infection, particularly for younger children. History and clinical examination do not always differentiate viral infections from bacterial infection. In 20% of febrile children, no infectious focus is found after examination and additional tests are necessary. The first one is measuring C-reactive protein (CRP). The results are obtained in several hours on an outpatient basis, causing long delays before starting treatment and often requiring telephone calls or further consultations. Emergency room use is constantly increasing, generating growing tensions within healthcare facilities, yet a large number of visits are avoidable. Among children visiting the pediatric emergency room, parents reported being referred by their primary care physician in approximately 20% of cases for children aged 1 to 5 years and in 30% of cases for children under one year old. The use of capillary medical device to measure CRP in primary care could reduce this referral rate and help relieve overcrowding in emergency rooms, as well as unscheduled consultation centers and medical analysis laboratories. This would result in a streamlined care pathway, saving time for both physicians and patients, as well as reducing the cost of care for the healthcare system.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Capillary CRP | Experimental |
| |
| Control | No Intervention | Prior to Capillary CRP condition |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Capillary CRP | Other | CRP measured semi-quantitatively using ACTIM-CRP device |
|
| Measure | Description | Time Frame |
|---|---|---|
| Referral rates to any facility equipped for emergency laboratory testing between conditions | Referral: Yes/No as reported by the physician | Day 1 |
| Referral rates to any facility equipped for emergency laboratory testing between conditions | Referral: Yes/No as reported by the parents | Day 7 |
| Measure | Description | Time Frame |
|---|---|---|
| Referral rates to medical biology laboratories between conditions | Referral: Yes/No as reported by the physician | Day 1 |
| Referral rates to medical biology laboratories between conditions | Referral: Yes/No as reported by the parents |
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Inclusion Criteria:
The patient must be a member or beneficiary of a health insurance plan
Children consulting primary health institutes with fever (temperature ≥ 38°C) requiring CRP testing:
No severity criteria necessitating immediate hospitalization
No bacterial infection whose diagnosis is exclusively clinical or identified by other means (e.g. purulent AOM, bacterial angina identified by RDT, etc.).
Child whose parents and child have been informed about the study, and at least one parent has given consent for their child's participation in the study.
Enrolment of the child according to their capacity of discernment (for children aged 12 and over, enrolment is essential).
Child affiliated to or benefiting from a health insurance scheme
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Chloé SIKIRDJI | Contact | 06.15.56.80.28 | chloe.sikirdji@umontpellier.fr |
| Name | Affiliation | Role |
|---|---|---|
| Chloé SIKIRDJI | Centre Hospitalier Universitaire de Nīmes | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre médical du Grau D'Agde | Recruiting | Agde | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41638749 | Derived | Griffiths K, Badin M, Bouvet S, Silvente L, Demattei C, Sikirdji C. Optimising the care pathway of febrile children via capillary C-reactive protein assay in primary care: the CRP-CAP cluster randomised stepped-wedge study protocol. BMJ Open. 2026 Feb 4;16(2):e109414. doi: 10.1136/bmjopen-2025-109414. |
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All IPD that underlie results in a publication
Upon publication
The IPD will be made available to other researchers upon reasonable request to the corresponding author
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Cluster randomized step wedge
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| Day 7 |
| Referral rates to emergency departments between conditions | Referral: Yes/No as reported by the physician | Day 1 |
| Referral rates to emergency departments between conditions | Referral: Yes/No as reported by the parents | Day 7 |
| Number complementary tests between conditions | Total number of tests as reported by the physician | Day 1 |
| Number complementary tests between conditions | Total number of tests as reported by the parents | Day 7 |
| Type of complementary tests between conditions | Qualitative listing of all further tests classified as: biological (CBC, venous CRP, iono/creatininemia, liver function tests, ECBU, others) or imaging (chest X-ray, abdomino-pelvic ultrasound, urinary and renal ultrasound) as reported by the physician | Day 1 |
| Type of complementary tests between conditions | Qualitative listing of all further tests classified as: biological (CBC, venous CRP, iono/creatininemia, liver function tests, ECBU, others) or imaging (chest X-ray, abdomino-pelvic ultrasound, urinary and renal ultrasound) as reported by the parents | Day 7 |
| GP satisfaction on care organization | 0-10 visual analog scale | Day 7 |
| The total duration of GP time between conditions | Minutes: measured as consultation time + examination time and time to inform the family | Day 7 |
| Parent satisfaction with the care pathway | 0-10 numeric scale | Day 7 |
| Rate of antibiotic prescription between conditions | Antibiotic prescription: Yes/No as reported by the physician | Day 1 |
| Rate of antibiotic prescription between conditions | Antibiotic prescription: Yes/No as reported by the parents | Day 7 |
| Duration of fever episode between groups | Days counted upon reaching 24 hours without fever | Day 7 |
| Cost-consequences between groups | euros | Day 7 |
| Budget impact analysis | euros | Day 7 |
| Cabinet Medical Baho | Recruiting | Baho | France |
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| MSP OLEA | Recruiting | Bezouce | France |
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| Msp Balmat Sante | Recruiting | Béziers | France |
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| MSP Espace Santé Servian | Recruiting | Béziers | France |
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| Msp Madeleine Bres | Recruiting | Bouillargues | France |
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| MSP Terre de Béliers | Recruiting | Bouillargues | France |
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| MSPU Avicenne | Recruiting | Cabestany | France |
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| MSP de Calvisson | Recruiting | Calvisson | France |
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| MSP de Clarensac | Recruiting | Caveirac | France |
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| Msp Au Fil de L'Hers | Recruiting | Deyme | France |
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| Msp Gigean | Recruiting | Gigean | France |
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| Cds de Ma Region | Recruiting | Le Vigan | France |
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| Msp Le Cube | Recruiting | Montgiscard | France |
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| MMG de Montpellier | Recruiting | Montpellier | France |
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| Msp La Mosson | Recruiting | Montpellier | France |
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| MSP Montpellier-Cévennes | Recruiting | Montpellier | France |
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| MMG de Narbonne | Recruiting | Narbonne | France |
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| Msp Narbo-Ouest | Recruiting | Narbonne | France |
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| CHU de Nîmes | Recruiting | Nîmes | France |
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| MMG de Nîmes | Recruiting | Nîmes | France |
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| MSP Charles GIDE | Recruiting | Nîmes | France |
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| CABINET MEDICAL Perpignan | Recruiting | Perpignan | France |
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| CABINET médical de l'Étang de l'Or | Recruiting | Pérols | France |
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| Mspu Pins Justaret | Recruiting | Pins-Justaret | France |
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| MSP de Pont Saint Esprit | Recruiting | Pont-Saint-Esprit | France |
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| MSPU Pauline Lautaud | Recruiting | Prades-le-Lez | France |
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| MSP Le Prisme | Recruiting | Remoulins | France |
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| Msp Du Thaurac | Recruiting | Saint-Bauzille-de-Putois | France |
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| CABINET MEDICAL Saint-Hippolyte-du-Fort | Recruiting | Saint-Hippolyte-du-Fort | France |
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| Msp Saint Jean-Du Gard | Recruiting | Saint-Jean-du-Gard | France |
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| MSP Saint-Laurent d'Aigouze | Recruiting | Saint-Laurent-d'Aigouze | France |
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| MSP Sud Minervois | Recruiting | Saint-Marcel-sur-Aude | France |
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| CDS Filieris Saint Martin de Valgalgues | Recruiting | Saint-Martin-de-Valgalgues | France |
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| Maison de santé de St Quentin la Poterie | Recruiting | Saint-Quentin-la-Poterie | France |
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| MSP Pezenas Tourbes | Recruiting | Tourbes | France |
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| Mspu La Source | Recruiting | Vergèze | France |
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| ID | Term |
|---|---|
| D005334 | Fever |
| ID | Term |
|---|---|
| D001832 | Body Temperature Changes |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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