The Oxford University Clinical Research Unit researchers in Vietnam have shown that using a fast 5-minute test they can reduce antibiotic misuse for respiratory infections. This is a key way to prevent the spread of antibiotic-resistant infection by cutting the number of unnecessary antibiotic prescriptions.
A marker of infections caused by bacteria, C-reactive protein (CRP), is detected in the patients’ blood by the rapid test. If they detect a low level of CRP it is suggestive of viral infection and an antibiotic is not required.
The tests were available by the study team at 10 primary healthcare centers around Hanoi and Vietnam and they recorded antibiotic use for 2000 participants who randomly were or were not tested for CRP. There was a significant reduction of antibiotic use in adults and children, and the clinical recovery remained the same. This investigation showed similar results to trials in Europe and this was the first trial to assess CRP tests for children.
Vietnam has unregulated access to antibiotics which makes them vulnerable for drug resistance development. They are also the world’s 14th most populous country with a rapidly developing economy. Even though infectious diseases are still one of the leading causes of death, resistance compromises treatment options. It was reported in 2014 by World Health Organization (WHO), that antibiotic resistance of common bacteria in community and hospitals had reached alarming levels worldwide. One of the priority areas to fight antibiotic resistance is by promoting new and rapid diagnostics to cut the unnecessary use of antibiotic.
The principal investigator, Prof. Heiman Wertheim, indicated there were large differences in the effect of the intervention between health centers. One center saw no effect due to antibiotic stocks they wanted to get rid of. With this easy to use tool, primary healthcare providers can safely limit the unnecessary antibiotic use for viral respiratory infections. This is important evidence for simple solutions in antibiotic stewardship programs. Further studies assessing the cost-effectiveness of this intervention are needed. This is evidence that the Ministry of Health can use for primary health care regulations to improve rational antibiotic use.
–Dr Fredda Branyon