Activities per year
Abstract
Objectives. Antibiotics are often prescribed for children with acute diseases in primary care, although
viral infections are dominant. C reactive protein (CRP) is an acute phase protein that can help to differentiate
viral and bacterial infections. We evaluate patient- and family physician (FP)-related predictors of antibiotic
prescribing and CRP testing before antibiotic prescribing in FP groups with and without access to CRP
point-of-care test (POCT).
Materials and Methods. 80 FP from from urban and rural practices in Latvia recorded data on pediatric
patients (1 month up to 17 years) who were consulted with acute infections (symptoms duration < 5 days).
The FP were divided into two groups of 40, one group had access to CRP POCT and control group
continued standard care.
Results. In total, 2,039 children with acute infections were enrolled in the study (n = 886 in control
group; n = 1153 CRP POCT group) with the median age 6.1 years. The most common infections were
upper (78.3% (n = 1597)) and lower (18.8% (n = 384) respiratory infections. In both groups 29.8%
received antibiotic prescription. Antibiotic prescribing was significantly associated with younger age of
children, middle-age of FP, a rural location of the FP practice and a larger number of registered paediatric
patients. The CRP level was frequently measured in the POCT CRP group (72.4% (n = 835)), compared
to only 8.8% (n = 78) in the control group, with an especially low level in rural practices (0,9%). 79.4% of
antibiotic prescriptions were preceded by CRP testing in the CRP POCT group compared to only 12.5%
in the control group.
Conclusions. In the absence of CRP POCT, especially in rural areas, patients undergo minimal CRP
testing prior to antibiotic prescribing, consequently leading to unwarranted antibacterial treatment. Younger
age of children, middle-age of FP, a rural location of the FP practice and a more registered paediatric
patients are associated with antibiotic prescribing.
viral infections are dominant. C reactive protein (CRP) is an acute phase protein that can help to differentiate
viral and bacterial infections. We evaluate patient- and family physician (FP)-related predictors of antibiotic
prescribing and CRP testing before antibiotic prescribing in FP groups with and without access to CRP
point-of-care test (POCT).
Materials and Methods. 80 FP from from urban and rural practices in Latvia recorded data on pediatric
patients (1 month up to 17 years) who were consulted with acute infections (symptoms duration < 5 days).
The FP were divided into two groups of 40, one group had access to CRP POCT and control group
continued standard care.
Results. In total, 2,039 children with acute infections were enrolled in the study (n = 886 in control
group; n = 1153 CRP POCT group) with the median age 6.1 years. The most common infections were
upper (78.3% (n = 1597)) and lower (18.8% (n = 384) respiratory infections. In both groups 29.8%
received antibiotic prescription. Antibiotic prescribing was significantly associated with younger age of
children, middle-age of FP, a rural location of the FP practice and a larger number of registered paediatric
patients. The CRP level was frequently measured in the POCT CRP group (72.4% (n = 835)), compared
to only 8.8% (n = 78) in the control group, with an especially low level in rural practices (0,9%). 79.4% of
antibiotic prescriptions were preceded by CRP testing in the CRP POCT group compared to only 12.5%
in the control group.
Conclusions. In the absence of CRP POCT, especially in rural areas, patients undergo minimal CRP
testing prior to antibiotic prescribing, consequently leading to unwarranted antibacterial treatment. Younger
age of children, middle-age of FP, a rural location of the FP practice and a more registered paediatric
patients are associated with antibiotic prescribing.
| Original language | English |
|---|---|
| Pages (from-to) | 73 |
| Number of pages | 1 |
| Journal | Medicina (Kaunas) |
| Volume | 59 |
| Issue number | Suppl.2 |
| Publication status | Published - 2023 |
Keywords*
- Antibiotic prescribing
- CRP
- CRP POCT
Field of Science*
- 3.3 Health sciences
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)
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Patient- and Family Physician-Related Predictors of Antibiotic Prescribing and Point-of-Care and Laboratory C Reactive Protein Testing before Decision Making in Rural and Urban Family Physician Practices in Latvia
Līkopa, Z. (Speaker), Ķīvīte-Urtāne, A. (Co-author) & Pavāre, J. (Co-author)
29 Mar 2023Activity: Talk or presentation types › Poster presentation