August 22, 2019

Background: Unwarranted use of antibiotics has several deleterious effects which include, antimicrobial resistance, wasted resources, adverse effects, negative affect on the microbiome of patients, and distracts from potentially more effective interventions. There has recently been a huge push for tests such as procalcitonin to help in curtailing the use of antibiotics when it is not warranted.  Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend only prescribing antibiotics in moderately or severely ill patients with acute COPD exacerbations, increased cough, and/or sputum purulence [2]. The authors of this trial wanted to test another such marker, point of care CRP in patients with acute COPD exacerbations.  Along with bronchodilators and steroids, antibiotic prescriptions seem to be a common treatment modality as well. CRP is an acute-phase protein that is readily available and can be measured quickly with point of care testing.  The authors of this trial hypothesized that the results of POC CRP may help inform prescribing decisions for acute COPD exacerbations, however RCTs regarding clinical effectiveness of this test are lacking.