CRP Testing Can Safely Reduce Antibiotic Use for COPD Exacerbations

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Using C-reactive protein (CRP) levels to guide treatment for chronic obstructive pulmonary disease (COPD) exacerbations can result in less antibiotic use without compromising clinical outcomes, a New England Journal of Medicine study finds.

Roughly 650 adults presenting to primary care with COPD exacerbations were randomized to usual care guided by CRP test results or usual care alone (controls). Clinicians were advised that antibiotics are unlikely beneficial for CRP lower than 20 mg/L, are possibly beneficial for CRP of 20–40 mg/L, and are likely beneficial for CRP above 40 mg/L.

Patients in the CRP group were significantly less likely than controls to report antibiotic use within 4 weeks after randomization (57% vs. 77%). COPD-related health status, meanwhile, was similar in the two groups.

Dr. Allan Brett, coauthor of the accompanying NEJM editorial, takes a closer look at these findings in NEJM Journal Watch General Medicine. Have a look at the first link below.