The National Institute for Health and Care Excellence (NICE) recommends that general practitioners (GPs) should perform a C-reactive protein (CRP) test before prescribing antibiotics for pneumonia, according to a news report from The Pharmaceutical Journal.

The CRP test if it is unclear whether a patient has pneumonia to ensure antibiotics are only prescribed when necessary. The guideline is aimed at helping GPs and hospital doctors follow the principles of antimicrobial stewardship so they only prescribe antibiotics when necessary.

The guidelines recommends that if a pneumonia diagnosis has not been made after a clinical assessment and it is not certain whether antibiotics should be prescribed, the physician should consider a CRP test, which is a point-of-care blood test that provides an assessment of inflammation. NICE recommends that antibiotics should be prescribed if the CRP concentration is greater than 100 mg/liter. The Journal news report notes that a delayed prescription should be considered if the CRP concentration is between 20 mg/litre and 100 mg/litre.

The guideline also states that antibiotics should not be offered routinely if the CRP concentration is less than 20 mg/litre.

Mark Baker, NICE’s director of clinical practice, says patients in need of antibiotics should be prescribed this medicine as early as possible. Baker states, “Accurate assessment of respiratory infections like pneumonia allows healthcare professionals to prescribe treatments responsibly. This both reduces costs and any potential harm from over-exposure to antibiotics.”

Toby Capstick, lead respiratory pharmacist at Leeds Teaching Hospitals NHS Trust, explains the, “CRP test might give a bit more information for the GP to determine whether it is likely to be pneumonia or significant infection that needs antibiotics, or a more mild lower respiratory tract infection or viral infection where antibiotics aren’t indicated. Potentially it could reduce inappropriate prescribing of antibiotics in primary care.”

Source: The Pharmaceutical Journal