Respiratory Infection, Respiratory Infections in Children
Conditions
Keywords
Respiratory Infections, C-reactive protein, antibiotic prescription
Brief summary
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.
Interventions
DIAGNOSTIC_TESTCare with C-reactive protein assay in micro method
Care with C-reactive protein assay in micro method
Sponsors
Association Clinique Thérapeutique Infantile du val de Marne
Centre Hospitalier Intercommunal Creteil
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
3 Years to No maximum
Healthy volunteers
No
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)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of antibiotic therapy prescribed | 10 days | with and without POCT-CRP |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of antibiotic therapy prescribed in patients aged from 3 to 17 years old | 10 days | with and without POCT-CRP |
| Frequency of antibiotic therapy prescribed in patients older than 65 years old | 10 days | with and without POCT-CRP |
| Type of antibiotic prescribed | 10 days | — |
| Frequency of complementary exam | 10 days | with and without POCT-CRP |
| type of complementary exam | 10 days | with and without POCT-CRP |
| Frequency of antibiotic therapy prescribed in patients aged from 18 to 64 years old | 10 days | with and without POCT-CRP |
| Proportion of number of patients with delayed antibiotic therapy | 10 days | with and without POCT-CRP |
| number of prescription following the recommended algorythms | 10 days | Adequacy between the proposed decision algorithm according to the C-reactive protein assay and the antibiotic prescription |
| Concordance between the prescription proposed by the decision algorithm as a function of the micro-CRP and the prescription realized: kappa coefficient | 10 days | The assessment of the utility of the POCT procedure |
| COVID-19 positive patients | 1 day | Number of COVID-19 positive patients by diagnostic method (From October 2020) |
| Proportion of number of patients referred to emergency | 10 days | with and without POCT-CRP |
Countries
France
Outcome results
None listed