1. Lower respiratory tract infections (LRTI)
Conditions
Interventions
PoC CRP assisted antibiotic prescribing including delayed prescribing compared to usual care.
Sponsors
University of Maastricht
Care and Public Health Research Institute
PO Box 616
6200 MD Maastricht
The Netherlands
Eligibility
Inclusion criteria
Inclusion criteria: The GPs will include adult patients (>=18 years) with acute LRTI or rhinosinusitis during normal consultation hours. The patient must meet the inclusion criteria listed below. Inclusion criteria: LRTI: First consultation of current episode of acute cough (duration <4 weeks) Regarded by the GP to be caused by an acute lower respiratory tract infection: 1. At least one out of following 4: Shortness of breath / wheezing / chest pain / auscultation abnormalities; 2. At least one of the following 5: Fever / perspiring / headache / myalgia / feeling generally unwell. Rhinosinusitis: First consultation of current episode of rhinosinusitis (duration <4 weeks) At time of consultation one of the following symptoms: 1. History of rhinorroe; 2. Blocked nose; AND one of the following symptoms/signs: 1. purulent rhinorroe; 2. unilateral facial pain; 3. headache; 4. teethpain; 5. pain when cheewing; 6. maxillary/frontal pain when bending over; 7. worsening of symptoms after initial improvement.
Exclusion criteria
Exclusion criteria: Exclusion criteria: 1. Patients who require immediate admission to hospital; 2. Patients who have no understanding of written and/or Dutch language; 3. Patients who previously participated in the study; 4. Patients who currently use antibiotic or have taken an antibiotic in the past 2 weeks; 5. Patients who have been hospitalized in the past 2 weeks; 6. Severely immuno-compromised patients.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Prescribing rates at index consultation (day 0), defined as immediate, delayed or no antibiotics. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary study parameters/outcome of the study (if applicable): 1. Total antibiotic exposure over a period of 28 days, defined as the number of patients receiving immediate antibiotics or filling a delayed prescription for antibiotics within 28 days of index consultation (day 0); 2. Clinical recovery; 3. Patient satisfaction and enablement; 4. Reconsultation within 28 days; 5. Evaluation of GPs' estimation of CRP value based on usual diagnostic work-up (medical history and physical examination) compared to actual CRP test result; 6. CRP value on day 0 and day 7 in relation to perceived degree of illness (VAS, Visual Analogue Scale). | — |
Contacts
Public ContactRogier Hopstaken
PO Box 616
Outcome results
None listed