Clinical Question

Are inflammatory biomarkers beneficial or harmful when used to guide antibiotic treatment for acute respiratory infections?

Evidence-Based Answer

C-reactive protein (CRP) point-of-care tests can reduce unnecessary antibiotic prescribing without delaying clinical recovery when used to inform treatment decisions for acute respiratory infections in primary care (number needed to test = 9; 95% CI, 6 to 14). (Strength of Recommendation [SOR]: A, consistent, good-quality patient-oriented evidence.) It remains unclear whether procalcitonin point-of-care tests affect antibiotic use or patient recovery.¹

Practice Pointers

A 2016 study using the 2010–2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey found that nearly one in three antibiotic prescriptions in U.S. ambulatory care settings was inappropriate.² Optimizing antibiotic prescribing practices in outpatient settings reduces the risk of antibiotic resistance, potential adverse drug effects, and harmful bacterial over-growth in patients and aligns with national and international public health goals.^3,4