title: Antibiotic prescribing and C-reactive protein testing for pulmonary infections in patients with intellectual disabilities.
abstract: BACKGROUND
  Excessive prescribing of antibiotics in patients with lower respiratory tract infections (LRTIs) is common in the general population. Due to communication difficulties, it is hypothesised that prescriptions are even more commonplace in the primary care of individuals with intellectual disabilities. Point-of-care C-reactive protein (POC-CRP) testing might lead to more efficient prescribing of antibiotics.
  
  
  OBJECTIVE
  To evaluate the effect of POC-CRP testing on antibiotic prescriptions for LRTIs by physicians specialising in the care of individuals with intellectual disabilities.
  
  
  METHODS
  A prospective case-control study in four care centres for individuals with intellectual disabilities in The Netherlands.
  
  
  METHODS
  Between 27 October 2010 and 27 October 2011, a prospective efficiency study was performed with a base population of 1472 individuals. This population consisted of 882 individuals in whom POC-CRP tests were used and a control group (n = 590) in whom no POC-CRP test was performed.
  
  
  RESULTS
  Of the 48 patients in the control group who were diagnosed as having an LRTI, 43 (90%) received antibiotics, compared with 59 out of the 144 patients (41%) in the case group (OR = 12.0; 95% CI = 4.1-35.3). No significant differences in outcome were found between both groups during a follow-up period of 1 month.
  
  
  CONCLUSIONS
  This study shows that the use of POC-CRP testing in patients with intellectual disabilities and LRTIs can lead to a significant reduction in antibiotic prescriptions, with no significant differences in outcome during follow-up.
authors: 's Heerenloo, Organisation For People With Intellectual Disabilities, Druten, The Netherlands. tinekepeters@gmail.com
authors: Catharina M
authors: CM
authors: Peters
authors: Francesca M
authors: FM
authors: Schouwenaars
authors: Ellen
authors: E
authors: Haagsma
authors: Heleen M
authors: HM
authors: Evenhuis
authors: Michael A
authors: MA
authors: Echteld
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011014:Pneumonia / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D019095:Point-of-Care Systems; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein
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