Greer Rachel C, Althaus Thomas, Dittrich Sabine, Butler Christopher C, Cheah Phaik Yeong, Wangrangsimakul Tri, Smithuis Frank M, Day Nicolas P J, Lubell Yoel
Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Healthc Low Resour Settings. 2023 Jul 6;11(1):11278. doi: 10.4081/hls.2023.11278.
C-reactive protein (CRP) point-of-care testing can reduce antibiotic prescribing in primary care patients with febrile and respiratory illness, yet little is known about its effects on treatment-seeking behavior. If patients go on to source antibiotics elsewhere, the impact of CRP testing will be limited. A randomized controlled trial assessed the impact of CRP testing on antibiotic prescriptions in Myanmar and Thai primary care patients with a febrile illness. Here we report patients' treatment-seeking behavior before and during the two-week study period. Self-reported antibiotic use is compared against urine antibacterial activity. Patients' opinions towards CRP testing were evaluated. Antibiotic use before study enrolment was reported by 5.4% while antimicrobial activity was detected in 20.8% of samples tested. During the study period, 14.8% of the patients sought additional healthcare, and 4.3% sourced their own antibiotics. Neither were affected by CRP testing. Overall, patients' satisfaction with their care and CRP testing was high. CRP testing did not affect patients' treatment-seeking behavior during the study period whilst modestly reducing antibiotic prescriptions. CRP testing appears to be acceptable to patients and their caregivers.
即时检测C反应蛋白（CRP）可减少基层医疗中发热和呼吸道疾病患者的抗生素处方，但对其对患者就医行为的影响知之甚少。如果患者转而从其他地方获取抗生素，CRP检测的影响将有限。一项随机对照试验评估了CRP检测对缅甸和泰国基层医疗中发热疾病患者抗生素处方的影响。在此，我们报告患者在为期两周的研究期之前及期间的就医行为。将自我报告的抗生素使用情况与尿液抗菌活性进行比较。评估了患者对CRP检测的看法。研究入组前报告有5.4%的患者使用过抗生素，而在20.8%的检测样本中检测到抗菌活性。在研究期间，14.8%的患者寻求了额外的医疗服务，4.3%的患者自行获取了抗生素。二者均未受CRP检测影响。总体而言，患者对其治疗及CRP检测的满意度较高。在研究期间，CRP检测未影响患者的就医行为，但适度减少了抗生素处方。CRP检测似乎为患者及其护理人员所接受。
