Published: 18 July 2019
A simple finger-prick blood test could help prevent unnecessary prescribing of antibiotics for people with the lung condition chronic obstructive pulmonary disease (COPD), according to NIHR-funded research.
Researchers from Cardiff University, University of Oxford and King’s College London demonstrated that using a 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 well-being or use of health care services over the following six months.
The PACE study is funded by the NIHR’s Health Technology Assessment (HTA) Programme and supported by the NIHR Clinical Research Network (CRN). A paper has been published in the New England Journal of Medicine (NEJM).
Safely reducing the use of antibiotics in this way may help in the battle against antibiotic resistance. 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.
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 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. People with a COPD flare-up who have a low CRP level in the blood appear to receive little benefit from antibiotic treatment.
Professor Hywel Williams, Director of the NIHR’s Health Technology Assessment (HTA) Programme, said: “This is a really important study which provides clear evidence that a simple biomarker blood test carried out in GP surgeries on people with chronic obstructive pulmonary disease experiencing flare-ups, has the potential to reduce unnecessary prescribing of antibiotics, without adversely affecting recovery from these flare-ups. This in turn helps tackle the wider global health hazards of antimicrobial resistance (AMR).
“The NIHR is committed to research in areas of greatest health need, such as AMR. This study is one of a number which we have funded over the last few years in this crucial area, in our sustained effort to tackle this worldwide threat.”
More information on the PACE study is available on the NIHR Journals Library website.