Usefulness of C-reactive Protein Testing in Acute Cough
Usefulness of C-reactive Protein Testing in Acute Cough
The aim of this study is to evaluate the usefulness in Russian general practice of C-reactive
 protein testing in patients with acute cough or lower respiratory tract infections.

 In addition to studying the effect of C-reactive protein testing on the prescription of
 antibiotics, the purpose is to find out whether the frequency of referral to radiography
 could be reduced.
Eighteen general practitioners, from both urban and rural offices, were randomised into
 intervention and control groups. All registrations were made by general practitioners in
 their offices.

 The case report form was similar to that used in the GRACE study (Genomics to combat
 Resistance against Antibiotics in Community-acquired lower respiratory tract infections in
 Europe (www.grace-lrti.org) describing symptoms, findings, and treatment in lower respiratory
 tract infections.

 -  The clinical examination included a chest examination and the axillary temperature.

 -  After the clinical examination, the general practitioners recorded their provisional
 diagnosis.

 -  Chest radiography was accessible for all patients.

 The C-reactive protein test was performed in the intervention group at both the first and
 second consultations. The Afinion test system was used, which provides results within 5
 minutes and before treatment was determined. This test is based on solid-phase sandwich
 immunometric analysis.

 General practitioners could prescribe any treatment, including antibiotics and other drugs
 for the cough and additional medication if deemed necessary.
Inclusion Criteria:

 -  patients with lower respiratory tract infections/acute cough (including acute
 bronchitis, pneumonia, and infectious exacerbations of chronic obstructive pulmonary
 disease or asthma),

 -  age 18 years or older,

 -  an illness of less than 28 days duration,

 -  first consultation for the illness episode,

 -  being seen in a physician's office,

 -  written consent to participate.

 Exclusion Criteria:

 -  an inability to fill out study documentation,

 -  being previously included in the study,

 -  immunocompromised status (HIV patients, immunosuppressive treatment),

 -  ongoing treatment with oral corticosteroids