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EBM verdict
Primary care
C reactive protein testing to guide antibiotic therapy for COPD exacerbations
  1. Annette Pluddemann
  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Dr Annette Pluddemann, Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; annette.pluddemann{at}phc.ox.ac.uk

https://doi.org/10.1136/bmjebm-2019-111294

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    A recent trial analysed the use of C reactive protein testing in guiding prescribing of antibiotics for exacerbations of chronic obstructive pulmonary disease in primary care.

    EBM Verdict

    EBM Verdict on: C-reactive protein testing to guide antibiotic prescribing for COPD exacerbations. N Engl J Med 2019;381:111–120. doi: 10.1056/NEJMoa1803185.

    • Using point-of-care C reactive protein tests in primary care to guide antibiotic prescribing for chronic obstructive pulmonary disease exacerbations significantly reduces antibiotic use. Implementation should consider feasibility and practicality, who might do the test and how testing affects the overall clinical decision pathway.

    C reactive protein (CRP) is a non-specific marker secreted in response to infectious and inflammatory triggers, and levels are typically highest in patients with a bacterial …

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    Footnotes

    • Contributors AP is the sole author.

    • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests AP reports grants from NIHR School of Primary Care Research Evidence Synthesis Working Group (NIHR SPCR ESWG project 390), and occasionally receives expenses for teaching evidence-based medicine. AP is an associate editor of BMJ EBM.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned; internally peer reviewed.