Point-of-care testing for C-reactive protein in acute cough presentations.

Abstract

Acute cough is one of the most common illnesses in the UK with an estimated 48 million cases per annum (Morice, McGarvey, Pavord, 2006). The majority of these presentations are thought to be of viral aetiology and self-limiting in nature (Woodhead et al, 2011), yet Meropol, Localio and Metlay (2013) report antibiotic prescription rates of approximately 65% in the UK. Clincians’ decision-making process can be influenced by both patient expectations and difficulty in differentiating between viral and bacterial aetiologies by clinical examination alone. Despite warnings about antimicrobial resistance (AMR) from the World Health Organisation (WHO, 2011) clinicians in the UK continue to have high prescription rates for acute cough presentations in comparison to other developed health care systems (Cooke et al, 2015; Smith et al, 2014; Hawker et al, 2014). This article will consider the feasibility, efficacy, benefits and limitations of using point of care testing (POCT) of C-reactive protein (CRP) within primary care in the United Kingdom to help inform management of acute cough.