Evaluating the evidence for the implementation of C-reactive protein measurement in adult patients with suspected lower respiratory tract infection in primary care: a systematic review

Abstract

The evidence for the benefits of POC CRP measurement in LRTI patients in primary care is limited, contradictory and does not support its use to guide treatment decisions yet.

The added value of C-reactive protein measurement in diagnosing pneumonia in primary care: a meta-analysis of individual patient data

“…In their systematic review, Engel and colleagues 4 concluded that the additional value of point-of-care CRP measurement in the management of respiratory tract infections in primary care is limited. Their review included 2 studies in which the diagnostic value of CRP was combined with either a prediction rule 22 or the physicians' presumptive diagnosis of pneumonia.…”

“…Adding CRP in the extended model increased the lowrisk group to 317 (32%). The number of patients with missed pneumonia who would be classified at low risk was 4 in both models; however, the proportion of false-negative results decreased with the addition of CRP, from 4 In the sensitivity analyses, these numbers changed in absolute values when we used different thresholds to define low, intermediate and high risk of pneumonia (data not shown).…”

Association between point-of-care CRP testing and antibiotic prescribing in respiratory tract infections: a systematic review and meta-analysis of primary care studies

“…A previous systematic review that studied the association between POC CRP testing and antibiotic prescribing only included patients with lower RTIs and identified five studies. 27 Comprehensive search strategies were performed to identify relevant studies. The search was not restricted to English language articles.…”

“…A systematic review conducted by Engel et al 27 concentrated on patients with lower RTIs only. They included both randomised and observational studies.…”

Strategy of rational antibacterial therapy of acute exacerbation of chronic obstructive pulmonary disease: an approach based on minimal hazard risk

“…Это связано с длительной колониза цией трахеобронхиального дерева как вне обостре ния, так и после успешной АБТ. Также не выявлено диагностической ценности таких маркеров бактери альной инфекции, как С реактивный белок и про кальцитонин [42][43][44][45]. Неправильная интерпретация симптомов, укладывающихся в рамки обострения, может быть обусловлена сложностями в диагности ке, прогрессирующей сердечной недостаточностью, бронхиальной астмой, тромбоэмболией ветвей ле гочной артерии [21].…”