Supporting Prudent Antibiotic use with CRP Point of CaRe testing fOr LRTIs in Wales (SPARROW)

Antibiotics are frequently prescribed in primary care for respiratory infections, although many patients may not benefit from them. This contributes to antimicrobial resistance (AMR), a major global health challenge. C-reactive protein (CRP) point-of-care tests can support decision-making by helping clinicians assess whether antibiotics are likely to be beneficial.

Although CRP point-of-care testing is recommended in guidelines, it is not widely used in routine NHS practice. There is limited evidence on how best to implement these tests at scale in real-world primary care settings. The national rollout of CRP testing in Wales provides a unique opportunity to understand how these tests are used in practice and how their use can be supported.

Aims:

This study aims to evaluate the implementation of CRP point-of-care testing in primary care across Wales, and to understand how its use can be supported in routine practice.

Specifically, we will:

• assess how CRP point-of-care testing is being used following national rollout, and its association with antibiotic prescribing and patient outcomes
• identify factors that influence the uptake and use of CRP point-of-care testing in practice
• co-design and evaluate approaches to support the appropriate and sustained use of CRP point-of-care testing in primary care

Why is this important

Antimicrobial resistance is a major global health challenge. Most antibiotics are prescribed in primary care, often for common respiratory infections where the benefits may be limited. While CRP point-of-care testing can support clinical decision-making, it is not widely used in routine NHS practice. There is limited evidence on how best to implement these tests at scale. This study addresses this gap by generating real-world evidence on how CRP testing is used in practice, and what helps or hinders its adoption. The findings are expected to inform strategies to support appropriate antibiotic use and improve patient care.

What we are doing:

We are evaluating the national rollout of CRP point-of-care testing across Wales using a mixed-methods approach. This includes surveys and interviews with healthcare professionals and patients, alongside analysis of routinely collected health data. We will also work with clinicians and members of the public to co-design approaches to support the use of these tests, including training and incentive-based strategies. These approaches will be implemented and evaluated in selected practices to assess their feasibility, acceptability, and potential impact.   

How this will benefit patients and the public

This study aims to support more informed decision-making about antibiotic use in primary care. By improving understanding of how CRP point-of-care testing is used in practice, it may help clinicians identify patients who are more likely to benefit from antibiotics. This could contribute to more personalised care and reduce unnecessary treatment. In the longer term, the findings may support efforts to address antimicrobial resistance and improve the management of respiratory infections in the community.