The role of CRP in COPD exacerbations and in antibiotic guidance
According to WHO data, chronic obstructive pulmonary disorder (COPD) was the third leading cause of death in 2016, followed by lower respiratory tract infections (LRTI).[1] Main cause of COPD is an ongoing irritation of the respiratory tract from smoking, followed by air pollution and inhalation of other chemical irritants (dusts, vapors, fumes, sprays).
A recent British study from Christopher Butler et al. was published in the New England Journal of Medicine on guidance of antibiotic prescription for COPD exacerbations by CRP-point of care tests in July 2019. The study was also highlighted by the AACC as ´a new role for C-reactive protein’.[1]
In COPD flare-ups, antibiotics had only little benefit for patients with a low CRP-level <20mg/L. So, in this study, antibiotic guidance was set to this cut-off value and the antibiotic use rate fell to 54% vs. 77% in the control group. The decline in antibiotic use did not show negative impact on the well-being of the patients in comparison to the control group. The well-being was followed over six months after attending their primary care physician and the recovery of the patients appeared to be similar in both groups. [1]
Antibiotic guidance has established over the last decades and gains increasing awareness. It aims at the optimization of antibiotic use while minimizing unintended consequences such as toxicity, the selection of pathogenic organisms and the emergence of resistance.
DiaSys offers CRP turbidimetric tests for the respons® system family and in kits suitable for a wide range of analyzers. With InnovaStar®, DiaSys also provides a dedicated Point-of-Care (POC) device for multiple parameters including CRP.
Innovastar® is a pre calibrated fully automated POC-System. CRP IS* has an excellent comparability to clinical chemistry analyzers with a measuring range from 5 – 400 mg/L from whole blood samples (10 µL capillary blood; total CV(CLSI): < 5%). The Innovastar® features with automatic hematocrit correction provide reliable results.
References:
[1] C.C. Butler, D. Gillespie, P. White, et al NEJM, 381, 111-120 (2019)
and “A new role for c-reactive protein” CLN Stat 15/08/2019
* IS = InnovaStar®
For more general information, please see https://www.who.int/respiratory/copd/causes/en/
