New evidence supports CRP POCT to guide antibiotic use in children
Aidian’s Medical Science Manager, Leena Meriläinen, wrote a short article for the journal of the Estonian Society for Laboratory Medicine (Eesti Laborimeditsiini Ühing) on new scientific evidence regarding the use of C-reactive protein (CRP) point-of-care testing (POCT) to guide antibiotic prescribing in children with respiratory symptoms in different healthcare settings. The original article was published in Estonian and is freely available here May 2026 issue of Eesti Laborimeditsiin on page 75. The main points of the article are summarized in English below.
Diagnostic uncertainty can lead to unnecessary antibiotic use in children
In children, antibiotic overprescribing is common and often driven by diagnostic uncertainty. Antibiotics may be prescribed “just in case” to avoid missing a potentially serious infections, although such infections are rare. Unnecessary antibiotic use contributes to antimicrobial resistance (AMR) and may also harm patients by causing adverse effects such as allergic reactions, diarrhoea, and changes in the gut microbiota.
CRP POCT has been shown to reduce antibiotic prescribing in adults with respiratory tract infections when used with defined cut-offs. However, until recently, the evidence on its use in children has been more limited.
CRP POCT can support better antibiotic use in children
In 2025, two large randomized controlled trials, COORDINATE1 and ARON2, evaluated the use of CRP POCT in children with respiratory symptoms or acute illness. The COORDINATE study was conducted in a low-resource primary care setting in Kyrgyzstan, whereas the ARON study was performed in a high-resource ambulatory care setting in Belgium.
The COORDINATE study used Aidian’s QuikRead go CRP test and found that CRP-guided prescribing safely reduced antibiotic use by 24% in a high-prescribing, resource limited setting.
In the ARON study, CRP POCT was implemented as part of multifaceted clinical decision tool that combined a clinical decision three, guided use of CRP results, and safety-netting advice for parents. The study showed that CRP POCT can add value when the result is interpreted and communicated within a structured clinical decision-making process.
CRP POCT in children supports antimicrobial stewardship
Together, these new studies strengthen the evidence base for using CRP POCT in children. They show that CRP POCT can be a useful tool for guiding antibiotic prescribing, although the optimal way to implement testing may differ between healthcare setting. The findings suggest that CRP POCT can support antimicrobial stewardship by reducing diagnostic uncertainty and helping clinicians safely avoid unnecessary antibiotic prescribing.
References
- Isaeva E et al. C-reactive protein testing in primary care and antibiotic use in children with acute respiratory tract infections in Kyrgyzstan: an open-label, individually randomised, controlled trial. Lancet Reg Health Eur 2025; 51: 101184. https://doi.org/10.1016/j.lanepe.2024.101184
Verbakel J et al. A clinical decision tool including a decision tree, point-of care testing of CRP, and safety-netting advice to guide antibiotic prescribing in acutely ill children in primary care in Belgium (ARON): a pragmatic, cluster-randomised, controlled trial. Lancet 2025; 406:1599-1610. https://doi.org/10.1016/S0140-6736(25)01239-5