New testing method could significantly reduce antibiotic prescribing – HIQA

A new form of testing could help reduce antimicrobial resistance which can cause illness and death from bacterial infections.

The Health Information and Quality Authority (HIQA) has recommended that C-reactive protein point-of-care testing (CRP POCT) should be introduced in a monitored pilot programme.

An estimated 2.4 million prescriptions are issued for respiratory tract infections in Ireland each year. HIQA believes that this number could be halved with the introduction of CRP POCT.

HIQA’s Chief Scientist, Dr Conor Teljeur said: “The method measures the levels of C-reactive protein in a person’s blood. A high level can be an indicator for bacterial infection which then helps the GP determine if the patient needs an antibiotic.”

At the moment, many GP’s often do not use the level of C-reactive protein as an indicator but are relying at their own clinical judgement of the patient’s symptoms.

Uncertainty in this approach leads to an overcautious response and to a high rate of antibiotic prescribing, especially for patients with acute respiratory tract infections (RTIs).

Studies have shown that increased antibiotic prescribing leads to increased antibiotic resistance, which causes approximately 700,000 deaths globally each year.

Dr Teljeur described the quick and easy nature of the new testing method, that “just takes a quick prick in the finger for a small sample.”

“The GP then puts it into table top device for testing and it only takes about ten minutes until you have a result.”

Older testing methods for C-reactive protein levels required blood samples to be sent into laboratories for testing, which led to long waiting times for doctors and patients.

While the new method has an error rate of about 5pc and results can only be an indicator for an infection, Dr Teljeur stressed that it “supports the decision making process, especially when the GP is unsure about the symptoms.”

In order to avoid frustration by GPs and patients with the new method and waiting times connected with it, HIQA’s Chief Scientist recommends a slow or partial roll-out in Ireland.

“GPs need to adapt their routines to the new method, while patients need to realize that antibiotics are not always the right treatment,” he said.

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