Impact of the Use of CRP on the Prescription of Antibiotics in General Practitioners (VIP)

Impact of the Use of C-reactive Protein in a Micro-method on the Prescription of Antibiotics in General Practitioners Consulting in the Office

Respiratory infections, including episodes of coughing with fever, are the main cause of outpatient antibiotic prescription, while a minority of them are linked to bacterial infections requiring antibiotic. These prescriptions are often performed by general practitioners. These unnecessary antibiotic contribute to increased bacterial resistance, side effects and unnecessary costs. Campaigns for the correct prescription of antibiotics have had a real but partial or transient success. C-reactive protein micro-method (POCT-CRP) could help to differentiate between viral and bacterial infections and thus contribute to the proper use of antibiotics. The decrease in prescription of antibiotics is likely to have an even stronger positive impact in countries like France, where prescription is high. The objective of this study is to evaluate the use of POCT-CRP in the general practitioner's office in case of suspected respiratory infection.

During a visit to the general practitioner for a clinical suspicion of respiratory infection, the doctor will practice a C-reactive protein assay in micro method. He will prescribe antibiotics according to the result of the dosage

Simple management of a patient coming for a suspicion of respiratory infection without dosage of the C-reactive protein in micro method

Adequacy between the proposed decision algorithm according to the C-reactive protein assay and the antibiotic prescription

Concordance between the prescription proposed by the decision algorithm as a function of the micro-CRP and the prescription realized: kappa coefficient

Inclusion Criteria: Age ≥ 3 years Clinical suspicion of respiratory infection defined by the presence of at least one respiratory sign among, cough, dyspnea, chest pain and auscultatory abnormality and at least one general sign among fever, sweat, headache, myalgia, impairment of general condition Affiliated to a social health insurance Signed consent Exclusion Criteria: Duration of symptoms < 24 hours Hospitalization or emergency assessment decision decided from the outset Signs of severity before the realization of POCT-CRP Patient previously included in the study for the same episode Antibiotic therapy within 7 days Chronic cough (more than 3 weeks)

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