C-reactive protein point-of-care testing to guide antibiotic prescribing for respiratory tract infections
Carl Llor
Abstract
INTRODUCTION: Antimicrobial resistance is strongly correlated with the volume of antibiotics used. Most antibiotics are prescribed in primary care, mostly for respiratory tract infections (RTIs), and are often unneeded. AREAS COVERED: The current knowledge regarding the use of C-reactive protein (CRP) rapid testing in primary care is outlined. A comprehensive literature search and narrative review of the evidence on CRP rapid testing for patients presenting with symptoms of RTIs was conducted to develop a holistic perspective on the subject. Relevant studies were identified through a PubMed search up to April 2025. EXPERT OPINION: CRP testing is an effective, cost-efficient tool to reduce unnecessary antibiotic use for lower RTIs in primary care. This test should be included in guidelines and implemented when a clinician is uncertain about the prognosis of an infection. It should complement history taking and clinical examination before deciding to prescribe antibiotics, primarily to rule out serious infections, but should never be used as a standalone test. To tackle antimicrobial resistance, the reduction of unnecessary antibiotic use in acute RTIs is optimized with clear guidance, advanced communication training for clinicians, and delayed antibiotic prescribing strategies when applicable.