Bacterial infections are among the leading causes of illness and death in children, particularly in low- and middle-income countries. Antibiotics are therefore frequently prescribed to children with signs of infection, even when the underlying cause may not be bacterial, contributing to unnecessary antibiotic use and antimicrobial resistance (AMR). C-reactive protein point-of-care testing (CRP POCT) can support clinical decision-making by helping healthcare workers distinguish between bacterial and non-bacterial infections and determine when antibiotics can be safely discontinued.
As part of an ICARS-supported project, researchers assessed the feasibility of using serial CRP POCT to guide antibiotic treatment decisions among children in two hospitals in Zanzibar. The study included 82 children and achieved a 96% follow-up rate. Key findings included:
- CRP testing was successfully integrated into routine clinical workflows.
- 89.7% of participating healthcare workers considered the intervention very important.
- Adherence to CRP-guided recommendations was high.
- Children receiving CRP-guided care had fewer antibiotic treatment days than those receiving standard care.
- Early discharge resulting from caregiver pressure was identified as an implementation challenge.
The findings suggest that a randomised controlled trial of serial CRP POCT to guide antibiotic treatment decisions is feasible and operationally implementable in this setting.
