Advanced Practitioner; Knowsley Community Respiratory Service, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool.
Consultant Physiotherapist; Knowsley Community Respiratory Service, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool.
Br J Community Nurs. 2022 May 2;27(5):218-224. doi: 10.12968/bjcn.2022.27.5.218.
Antibiotic resistance presents a growing threat to health systems and patients at a global scale. Point of care (POC) C-reactive protein (CRP) measurement, as an adjunct to exacerbation assessment, has been studied in primary and secondary care and may represent a useful tool for community teams. A retrospective service review was conducted to determine the effect of CRP measurement on antibiotic provision in a community respiratory setting, with chronic obstructive pulmonary disease (COPD) and bronchiectasis exacerbations. This review compared antibiotic provision for COPD and bronchiectasis patients for those where CRP was measured versus those where it was not. It was found that antibiotic provision dropped by almost 25% points for COPD exacerbations, and almost 59% in bronchiectasis, when a CRP measurement was taken as a component of a respiratory assessment. Antibiotics were also provided at a greater amount based on symptom presentation. Therefore, it is concluded that CRP measurement correlates with a reduction in antibiotic provision, highlighting its use alongside symptom assessment in future work.
抗生素耐药性在全球范围内对卫生系统和患者构成的威胁日益严重。在初级和二级保健中，已经研究了将即时护理（POC）C 反应蛋白（CRP）测量作为加重评估的辅助手段，它可能是社区团队的一种有用工具。进行了一项回顾性服务审查，以确定 CRP 测量在社区呼吸系统环境中对 COPD 和支气管扩张症加重患者的抗生素提供情况的影响。该审查比较了 CRP 测量的 COPD 和支气管扩张症患者与未进行 CRP 测量的患者的抗生素提供情况。结果发现，当 CRP 测量作为呼吸评估的一部分时，COPD 加重的抗生素提供量下降了近 25%，而支气管扩张症则下降了近 59%。根据症状表现，抗生素的提供量也更大。因此，可以得出结论，CRP 测量与抗生素提供量的减少相关，这突出了在未来工作中与症状评估一起使用 CRP 测量的重要性。
