The use of CRP tests in patients with respiratory tract infections in primary care in Sweden can be questioned

被引:45
作者
André, M
Schwan, Å
Odenholt, I
机构
[1] Clin Res Ctr, SE-79182 Falun, Sweden
[2] Linkoping Univ, Fac Hlth Sci, Dept Med & Care, Linkoping, Sweden
[3] Uppsala Univ, Dept Publ Hlth & Caring Sci Family Med, Uppsala, Sweden
[4] Univ Hosp, Dept Infect Dis, Malmo, Sweden
关键词
D O I
10.1080/00365540410019372
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
A diagnosis-antibiotic prescribing study was performed in 5 counties in Sweden during 1 week in November in 2000 and 2002 respectively. As a part of the study, the use and results of C-reactive protein (CRP) tests in relation to duration of symptoms and antibiotic prescribing in 6778 patients assigned a diagnosis of respiratory tract infections were analysed. In almost half (42%) of the patients, a CRP test was performed. The majority of CRP tests (69%) were performed in patients assigned diagnosis upper respiratory tract infection, where the test is not recommended. Overall, there was a minor decrease in antibiotic prescribing when CRP was used (41%), in comparison to 44% of the patients where no CRP was performed (p<0.01). Patients assigned diagnoses implying a bacterial aetiology were prescribed antibiotics irrespective of result of CRP or length of symptoms before consultation. For patients assigned viral diagnoses, antibiotic prescribing increased with increasing duration of symptoms and increasing value of CRP. The use of CRP decreased antibiotic prescribing in patients assigned to viral diagnoses and with longstanding symptoms (p<0.001). However, 59% of the patients assigned viral diagnoses with CRPgreater than or equal to25 received antibiotics, which seems to indicate a misinterpretation of CRP and a non-optimal use of antibiotics.
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收藏
页码:192 / 197
页数:6
相关论文
共 39 条
[11]   PREDICTING ACUTE MAXILLARY SINUSITIS IN A GENERAL-PRACTICE POPULATION [J].
HANSEN, JG ;
SCHMIDT, H ;
ROSBORG, J ;
LUND, E .
BRITISH MEDICAL JOURNAL, 1995, 311 (6999) :233-236
[12]  
Heiskanen-Kosma T, 2000, SCAND J INFECT DIS, V32, P399, DOI 10.1080/003655400750044971
[13]  
HJORTDAHL P, 1991, Scandinavian Journal of Primary Health Care, V9, P3, DOI 10.3109/02813439109026574
[14]  
Hjortdahl Per, 1994, Scandinavian Journal of Primary Health Care, V12, P70, DOI 10.3109/02813439409003678
[15]  
Hopstaken RM, 2003, BRIT J GEN PRACT, V53, P358
[16]  
HOWIE JGR, 1983, SCAND J INFECT DIS, P68
[17]  
Hutchinson JM, 2001, CAN FAM PHYSICIAN, V47, P1217
[18]   Evidence base of clinical diagnosis - Evaluation of diagnostic procedures [J].
Knottnerus, JA ;
van Weel, C ;
Muris, JWM .
BMJ-BRITISH MEDICAL JOURNAL, 2002, 324 (7335) :477-480
[19]   Should general practitioners perform diagnostic tests on patients before prescribing antibiotics? For [J].
Kolmos, HJ .
BRITISH MEDICAL JOURNAL, 1999, 318 (7186) :799-800
[20]   THE VALUE OF C-REACTIVE PROTEIN AS A MARKER OF BACTERIAL-INFECTION IN PATIENTS WITH SEPTICEMIA ENDOCARDITIS AND INFLUENZA [J].
LINDBACK, S ;
HELLGREN, U ;
JULANDER, I ;
HANSSON, LO .
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, 1989, 21 (05) :543-549