CRP POCT test for diagnosis of respiratory infections in children in Kyrgyzstan: the randomised controlled clinical trial

Introduction: Acute respiratory tract infections (ARI) are a serious problem in Central Asia, particularly in Kyrgyzstan. C-reactive protein (CRP) is an acute inflammatory protein, which increases due to a bacterial infection. It is an established biomarker for assessing need of antibiotics in children with ARIs presenting to a healthcare facility and quite useful as a point-of-care test (POCT). There are many studies worldwide on the effectiveness of this diagnostic method, but studies in children are lacking, as are studies from Kyrgyzstan. This trial aims to investigate the effectiveness of CRP POCT method at the primary care level in recognising bacteria caused infections, thereby reducing the unnecessary prescription of antibiotics. This will be a great contribution to the fight against antibiotic resistance in Kyrgyzstan, especially in primary care. Method: Individual randomised controlled clinical trial with 14 days blinded follow-up. The primary outcome will be an antibiotic prescription within 14 days from the index consultation, measured as proportion of children in each study group who receive an antibiotic. The second primary outcome is patient safety measured as the number of days until recovery. Results: The data collection is ongoing. We expect data collection to be completed in mid-March 2023. Discussion: Last year our pilot study showed that CRP POCT resulted in fewer antibiotics being prescribed to children, and the parent-reported cure rate was almost the same in the implementation and control groups. After analysis, we will present preliminary data at the conference.