Near-patient CRP testing by physicians in private practice to reduce antibiotic prescriptions

Wild C, Hahn R
Record ID 32001000020
Authors' objectives:

This report aims to provide information on the potential of the C-reactive protein (CRP) test to reduce antibiotic prescriptions.

The assessment focuses on the validity of near-patient CRP test systems and established alternatives, and their relevance for diagnosing viral or bacterial diseases typical in ambulant patients.

A second section of the report focuses on the general prescription behavior of physicians in private practice and the impact of the near-patient CRP tests on antibiotic prescriptions.

Authors' results and conclusions: - The (semiquantitative) near-patient CRP test is exact enough to diagnose infectious diseases and to help differentiate between viral and bacterial infections. - In most cases, the near-patient CRP test is superior to alternative near-patient systems because of its specificity in diagnosing the acute phase reaction, and its practicability (faster, less blood required). - Because many factors influence antibiotic prescription behavior, a decline in antibiotic prescriptions cannot be expected. - A reduction in transfers to external laboratories and related costs (additional tests) can be expected.
Authors' recomendations: CRP testing is an established method to diagnose and monitor infectious diseases. While the (quantitative) CRP tests carried out in hospitals or ambulant laboratories are not under question, the semiquantitative tests that can be carried out within minutes in a physicians practice are not yet reimbursed by most Austrian health insurers. General practitioners and pediatricians argue in favor of reimbursement on the grounds that the CRP test might be a powerful tool to reduce the amount of antibiotics prescribed. This report concludes that the (semiquantitative) near-patient CRP test should be reimbursed. To exclude the possibility for added applications of CRP and an alternative test, optional reimbursement should leave an either-or decision to the physician.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 2000
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Austria
MeSH Terms
  • C-Reactive Protein
  • Disease Progression
  • Physicians, Family
  • Bacterial Infections
Organisation Name: Institute of Technology Assessment
Contact Address: Ludwig Boltzmann Institut fur Health Technology Assessment, Garnisongasse 7/rechte Stiege Mezzanin (Top 20) 1090 Vienna, Austria. Tel: +43 (0)1 236 8119 12; Fax: +43 (0)1 236 8119 99
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Copyright: Institute of Technology Assessment (ITA)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.