Rapid CRP tests reduce antibiotic misuse & development of antibiotic resistance

Researchers from the Oxford University Clinical Research Unit (OUCRU), a large-scale clinical and public health research unit based in Vietnam, have found that the use of a 5-minute test can assist in the ongoing fight against antibiotic resistance by reducing antibiotic misuse for respiratory infections, according to a press release published by Oxford University.

Antibiotic resistance has quickly become a worldwide threat, especially in underdeveloped countries as infectious diseases are rampant and the new antibiotics to treat them are expensive and not readily available.

According to the study, Vietnam already has a lot of antibiotic resistance. The authors report that Steptococcus pneumoniae has become 71% resistant to penicillin and 92% resistant to erythromycin, the highest resistance percantages in Asia. Similarly, Pseudomonas aeruginosa and Acinetobacteru baumannii are 25% and 40% resistant to Carbopenem, respectively.

The authors go on to explain that the reason for this high level of resistance has much to do with the fact that most antibiotics are purchased without prescription from private pharmacies. An important factor in combating resistance is cutting the number of unnecessary antibiotics, and these rapid tests are effectively doing so.

The tests detect C-reactive protein (CRP), a substance produced by the liver that typically increases in the presence of inflammation. Elevated CRP levels indicate infection or long-term disease caused by bacteria in the patient’s blood. When blood tests show a low level of CRP, that suggests that the patient has developed a viral infection, such as a cold, the flu, or a sore throat, which means that antibiotic treatment is not required.

The Centers for Disease Control and Prevention stresses in a feature entitled “Antibiotics Aren’t Always the Answer,” that when it comes to viral infections, antibiotics will not be effective in treatment. They will not cure viral infections, will not prevent others from developing the infection, and will not work to improve symptoms. In fact, using antibiotics for viral infections could actually cause harmful side effects in patients.

These rapid CRP tests can report the levels of C-reactive protein, which can reduce the misuse of antibiotics when it comes to treatment.

OUCRU researchers made the tests available at 10 primary healthcare centers in and around Hanoi, Vietnam, and documented the antibiotic use of 2000 patients (adults and children) who randomly were or were not tested for C-reactive protein. This was the first trial to assess CRP tests for children and the first to investigate this in a resource-constrained setting, according to the press release. The results found that point-of-care CRP testing helped reduce the use of antibiotics for non-severe respiratory infections without compromising the patient’s recovery.

When speaking on the implications of this discovery, Prof Nguyen Van Kinh, investigator and director of the National Hospital for Tropical Diseases, said, in University of Oxford’s press release, “With this easy-to-use tool, primary healthcare providers can safely limit the unnecessary antibiotic use for viral respiratory infections. The study provides important evidence for simple solutions in antibiotic stewardship programmes.” He notes that this trial has provided the necessary data for planning the possible enablement of large scale implementation of this intervention. Further studies need to be conducted to assess the cost-effectiveness of this intervention.