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\begin{document}

\title{The use of CRP testing and prescription of antibiotic therapy: a
population-based study in primary care}



\author[1]{Francesco Lapi}%
\author[1]{Ettore Marconi}%
\author[2]{Alessandro Rossi}%
\author[2]{Erik Lagolio}%
\author[3]{Ercole Concia}%
\author[1]{Claudio Cricelli}%
\affil[1]{Health Search}%
\affil[2]{Italian College of General Practitioners and Primary Care}%
\affil[3]{University of Verona}%


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  \date{May 27, 2024}


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\begin{abstract}
The C-reactive protein (CRP) can guide the antibiotic prescription for
infectious diseases which are likely viral. We identified all patients,
aged 15 years or older, being registered in the database between
January, 1, 2000 and December, 31, 2019 and newly diagnosed with upper
respiratory tract infections (URTIs), COPD- or asthma-related
exacerbations. From the date of these diagnoses, patients were followed
up until occurrence of antibiotic prescription (for these indications)
up to December 31, 2019. The association between the prescription of CRP
and the outcome was investigated using a nested case-control analysis.
In a cohort of 469,684 patients being diagnosed for URTI (83\%), COPD-
(11\%) and asthma (7\%)-related exacerbations, 28688 (6.11\%) were
prescribed with antibiotics because of the aforementioned indications.
Of note, 98\% of cases were not tested with CRP. Those receiving
antibiotics showed a greater propensity to be previously tested for CRP
than related controls. Our findings indicate that most of the antibiotic
prescriptions for the investigated conditions did not report prior
evaluation of CRP values. Nevertheless, it seems that some GPs properly
used CRP before deciding for an antibiotic therapy. Further information
and incentives in using CRP test should be therefore sustained in
primary care.%
\end{abstract}%



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