Real-world insights on C-reactive protein point-of-care testing: lessons from a Belgian implementation study

In Belgium, overprescribing of antibiotics remains a major issue despite the extensive efforts to reduce unnecessary antibiotic use. A key factor contributing to unnecessary antibiotic prescribing for respiratory tract infections is diagnostic uncertainty, particularly the difficulty to distinguish self-limiting infections from those that may require treatment based on clinical examination alone.

Scientific literature has widely shown that C-reactive protein (CRP) point-of-care testing (POCT) supports more appropriate antibiotic prescribing in adults with lower respiratory tract infection (LRTI), including acute cough. CRP POCT is already included in clinical guidelines for the management of acute cough and other LRTIs in countries such as the Netherlands and the UK. However, in Belgium, CRP POCT has not yet been widely implemented in primary care. Before broader adoption can be considered, it is important to understand not only the clinical value of the test, but also how it fits into daily general practice and what practical, organizational, and economic factors may support or limit implementation.

A recently published study aimed to investigate the potential barriers and facilitators for CRP POCT implementation in Belgium primary care where focus group discussions were conducted with 32 general practitioner’s (GP’s) and other relevant key stakeholders. Aidian's QuikRead go easy CRP was one of the CRP POCT devices included in the study.

CRP POCT supports clinical decision-making and patient communication

The study found that CRP POCT has clear potential in Belgian primary care when implemented with appropriate support. Physicians considered CRP POCT valuable especially in three situations:

1. As an objective tool to reduce diagnostic uncertainty

General practitioners described CRP POCT as a useful and objective addition to clinical examination and professional judgement. When used together with clinical assessment, CRP can help support treatment decisions.

2.  Improving communication to the patients

Physicians considered CRP results as a good tool when explaining antibiotic prescribing decisions to patients. This was considered particularly useful when antibiotics were withheld, as the test result provided an additional, concrete basis for the discussion.

3. Supporting decision-making in paediatric care

Although the study focused on adults with acute cough, physicians repeatedly highlighted the value of CRP POCT in children. In paediatric care, diagnostic uncertainty may be higher, and rapid CRP results from a small volume of  blood may help support referral decisions, reassure parents, and avoid more invasive blood sampling when appropriate.

Implementation requires more than the device

The study underlines that successful large-scale implementation of CRP POCT requires clear guidelines on CRP cut-off values and indications, smooth integration into clinical workflows, consistent quality control processes, continued technical support from laboratories and manufacturers, and a reimbursement model that supports access while minimizing unnecessary use. 

Overall, the findings suggest that CRP point-of-care testing can support more appropriate antibiotic prescribing and contribute to antimicrobial stewardship in Belgian primary care. With the right implementation framework, CRP POCT has the potential to become an important tool for supporting diagnostic and therapeutic decisions in everyday general practice.

Reference:

Dankaerts et al. Evaluation of the implementation process of POC-CRP devices in managing adults with cough in general practice: insights from a focus group study. Archives of Public Health. 2026;84:70.