The value of point-of-care CRP testing in acutely ill children presenting to out-of-hours services.

Managing acutely ill children in an out-of-hours service is challenging because of the relatively low prevalence of serious illnesses (mainly infections such as pneumonia, urinary tract infections and sepsis) and the aspecific presentation of most children. Adding a CRP test to the diagnostic process, which provides a result in 4 minutes, may improve referral decisions and antibiotic prescribing. However, it is not clear whether parents would accept their children to receive a point-of-care test that involves a finger prick.This is a pilot study on implementing a CRP point-of-care test in an out-of-hours service. The main outcome was recruitment rate to the study, and secondary outcomes were tentative effects on referral rates and antibiotic prescribing, and parental and clinician acceptability.Children presenting to two out-of-hours services in Oxfordshire with an acute illness of a maximum of five days were eligible. All children for whom informed consent was obtained had their vital signs (heart and breathing rate, temperature and capillary refill time) measured. Children with a temperature of at least 38 degrees, either measured at the out-of-hours service or at home within the last 4 hours, were subsequently randomised to CRP testing or no CRP testing. Follow-up information was collected at the out-of-hours service and from the children's regular GP practice.During the study period, 324 children were eligible for inclusion in the study. Of these, 203 were recruited after informed consent, corresponding with a consent rate of 67.7% (95% CI 62.05-72.93). Further analyses are currently ongoing and will be available by June.

Credits

• Ann Van den Bruel
• Caroline Jones