23rd July 2019
Finger-prick blood test could safely reduce antibiotic use for people with chronic lung disease
A new study, involving researchers from the Centre for Trials Research and the Wales Centre for Primary and Emergency Care Research (PRIME Centre Wales), has found a simple finger-prick blood test at a GP surgery could prevent the unnecessary prescribing of antibiotics to people with chronic obstructive pulmonary disease (COPD).
More than a million people in the UK have COPD, which is a lung condition associated with smoking and other environmental pollutants.
People living with the condition often experience exacerbations, or flare-ups, and when this happens, three out of four are prescribed antibiotics. However, two thirds of these flare-ups are not caused by bacterial infections and antibiotics often do not benefit patients.
The finger-prick test measures the amount of C-reactive protein (CRP) – a marker of inflammation that rises rapidly in the blood in response to serious infections.
With funding from the National Institute for Health Research, researchers on the ‘Point of care testing to target antibiotics for chronic obstructive pulmonary disease exacerbations’ (PACE) study – from Cardiff University, University of Oxford and King’s College London – demonstrated that using the CRP finger-prick blood test resulted in 20% fewer people using antibiotics for COPD flare-ups.
Importantly, this reduction in antibiotic use did not have a negative effect on patients’ recovery over the first two weeks after their consultation at their GP surgery, or on their wellbeing or use of health care services over the following six months.
Safely reducing the use of antibiotics in this way may help in the battle against antibiotic resistance.
Professor Nick Francis, from Cardiff University’s School of Medicine, said: “Governments, commissioners, clinicians, and patients living with COPD around the world are urgently seeking tools to help them know when it is safe to withhold antibiotics and focus on treating flare-ups with other treatments.
“This is a patient population that are often considered to be at high risk from not receiving antibiotics, but we were able to achieve a reduction in antibiotic use that is about twice the magnitude of that achieved by most other antimicrobial stewardship interventions, and demonstrate that this approach was safe.”
The Centre for Trials Research and PRIME Centre Wales both receive funding from Health and Care Research Wales.
Through the Health and Care Research Wales public involvement community, Jonathan Bidmead and Margaret Barnard became the patient and public representatives on the PACE study.
Jonathan commented: “We need to highlight not only how many people are saved by antibiotics but also that many are harmed though unnecessary antibiotic use. As a COPD sufferer, I know that antibiotics are routinely used at the first sign of an exacerbation: this study has shown that doctors can use a simple finger-prick test in a consultation to better identify those instances where antibiotics will probably do no good and may even do some harm. This can help us focus on other treatments that may be more helpful for some exacerbations.”
The research, ‘C-reactive Protein Guided Antibiotic Prescribing for COPD Exacerbations’, has been published in the New England Journal of Medicine, and a summary video from the study is available to watch on YouTube.
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This study is funded by the National Institute for Health Research (NIHR) [HTA programme (12/33/12)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.