Respiratory Tract Infections
Conditions
Keywords
antibiotics, primary care, radiology/radiography, respiratory tract infections
Brief summary
The aim of this study is to evaluate the usefulness in Russian general practice of C-reactive protein testing in patients with acute cough or lower respiratory tract infections. In addition to studying the effect of C-reactive protein testing on the prescription of antibiotics, the purpose is to find out whether the frequency of referral to radiography could be reduced.
Detailed description
Eighteen general practitioners, from both urban and rural offices, were randomised into intervention and control groups. All registrations were made by general practitioners in their offices. The case report form was similar to that used in the GRACE study (Genomics to combat Resistance against Antibiotics in Community-acquired lower respiratory tract infections in Europe (www.grace-lrti.org) describing symptoms, findings, and treatment in lower respiratory tract infections. * The clinical examination included a chest examination and the axillary temperature. * After the clinical examination, the general practitioners recorded their provisional diagnosis. * Chest radiography was accessible for all patients. The C-reactive protein test was performed in the intervention group at both the first and second consultations. The Afinion test system was used, which provides results within 5 minutes and before treatment was determined. This test is based on solid-phase sandwich immunometric analysis. General practitioners could prescribe any treatment, including antibiotics and other drugs for the cough and additional medication if deemed necessary.
Interventions
DEVICEC-reactive protein test
Results provides within 5 minutes. This test is based on solid-phase sandwich immunometric analysis. The measurement range in whole blood samples is 8-200 mg/L.
Sponsors
University of Tromso
Northern State Medical University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients with lower respiratory tract infections/acute cough (including acute bronchitis, pneumonia, and infectious exacerbations of chronic obstructive pulmonary disease or asthma), * age 18 years or older, * an illness of less than 28 days duration, * first consultation for the illness episode, * being seen in a physician's office, * written consent to participate.
Exclusion criteria
* an inability to fill out study documentation, * being previously included in the study, * immunocompromised status (HIV patients, immunosuppressive treatment), * ongoing treatment with oral corticosteroids
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| the antibiotic prescribing rate | within the first 2 weeks after first consultation |
Secondary
| Measure | Time frame |
|---|---|
| referral to radiography | within the first 2 weeks after first consultation |
Other
| Measure | Time frame | Description |
|---|---|---|
| rate of recovery at the follow-up consultation | within the first 2 weeks after first consultation | Rate of recovery at the follow-up consultation after 2 weeks with the following five alternatives: fully recovered, almost recovered, slightly improved, unchanged, and worse. Consultations with the general practitioner within 2 weeks and complications (in need of hospitalisation) were recorded. |
Countries
Russia
Outcome results
None listed