Impact of C-reactive Protein Micromethod Testing in Primary Care on Antibiotics Delivery in Patients With Upper or Lower Respiratory Tract Infections

Impact of C-reactive Protein Micromethod Testing in Primary Care on Antibiotics Delivery in Patients With Upper or Lower Respiratory Tract Infections: a Randomized Pragmatic Intervention Trial

The project is a pragmatic approach to primary care. The main objective is to evaluate the impact of making a CRP measurement device available in primary care general practices on antibiotic prescribing for upper respiratory tract (URT) or lower respiratory tract (LRT) infections.

Inclusion Criteria:

• Patients who have received information and given written consent
• Patients of any age consulting a general practice with one or more of the following symptoms: fever, cough, arthralgias, myalgias, rhinorrhea;
• Symptomatology evolving for more than 24 hours;
• Symptoms associated with an upper respiratory tract infection such as otitis, angina, laryngitis, rhinopharyngitis, sinusitis; and/or a lower respiratory tract infection such as acute bronchitis, pneumonia, exacerbation of COPD (chronic obstructive pulmonary disease).

Exclusion Criteria:

These criteria correspond to factors making interpretation of the CRP value difficult:

• Antibiotics taken in the 15 days prior to inclusion
• Presence of one of the following signs of severity requiring immediate hospitalization:

Impairment of higher functions (altered consciousness) Sign of severity (Pas<90mmHg; HR>120/min; FR>30 cycles/min) Temperature <35 or >40°c Inhalation pneumonitis

• Sepsis: organ dysfunction, FR>22cycles/min, PAS≤100 mmHg and Galsgow score ≤ 13(34)
• Immediate hospitalization
• Pregnancy
• Burns
• Heat stroke
• Presenting with an associated serious pathology:
• Associated neoplastic disease in progress
• Severe liver failure
• Ischemic or thromboembolic pathology
• Traumatic pathology
• Inflammatory rheumatism
• Autoimmune disease