Impact of C-reactive protein testing on adherence to thrice-daily antibiotic regimens in patients with lower respiratory tract infection

Background: Few studies have analysed adherence to antibiotic treatment in respiratory tract infections. Objective: To evaluate the impact of C-reactive protein (CRP) testing on treatment adherence among patients aged 18 or over with lower respiratory tract infection (LRTI) treated with thrice-daily antibiotic regimens. Design: Prospective study 2003 - 2008. Setting: Office-based physician practices. Methods: We compared patient adherence prior to the use of CRP testing (no CRP test was available prior to 2007) with adherence following CRP rapid testing for suspected bacterial infection in LRTIs. Patient adherence was assessed by electronic monitoring. Results: 161 patients with LRTI were recruited. The percentage of container openings was 76.8 +/- 17.4%. Adherence was significantly better when the CRP test was performed (83.3% vs. 74.4%; p<0.01), as was 'good timing' adherence during at least 80% of the antibiotic course (32.6% vs. 16.9%; p<0.05). Conclusion: Greater antibiotic treatment adherence is observed among patients with LRTI after CRP testing at the consultation prior to administration of antibiotic treatment. (c) 2010 Primary Care Respiratory Society UK. All rights reserved. C Llor et al. Prim Care Resp J 2010; 19(4): 358-362 doi:10.4104/pcrj.2010.00023