Comparing antimicrobial use in febrile patients with and without C-reactive protein testing
Rapid Diagnostic Testing for C-reactive Protein to Differentiate Bacterial and Viral Infection in Febrile Patients to Reduce Antimicrobial Use in Remote Health Care Centers of Gulmi District of Nepal: a Cluster Randomized Controlled Trial
This study is testing whether using a simple blood test for C-reactive protein can help doctors in rural Nepal prescribe fewer antibiotics for patients with fever by better identifying if their infection is bacterial or viral.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 924 (estimated) |
| Ages | 1 Year and up |
| Sex | All |
| Sponsor | Patan Academy of Health Sciences Academic / other |
| Locations | 1 site (Resunga Nagarpalika, Lumbini) |
| Trial ID | NCT05292508 on ClinicalTrials.gov |
What this trial studies
This study aims to evaluate the impact of using C-reactive protein (CRP) testing on the prescription rates of antimicrobials in febrile patients in rural Nepal. By conducting a cluster-randomized controlled trial across eight health posts, the researchers will compare the standard care approach, which relies on clinical features alone, to the CRP test, which helps differentiate between bacterial and viral infections. The goal is to reduce unnecessary antimicrobial prescriptions and combat antimicrobial resistance in the region.
Who should consider this trial
Good fit: Ideal candidates for this study are individuals with a reported fever lasting up to 7 days who can connect via mobile phone for follow-up.
Not a fit: Patients with conditions requiring immediate hospital referral or those with confirmed infections such as malaria or urinary tract infections may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could lead to more appropriate use of antimicrobials, reducing the risk of antimicrobial resistance and improving patient outcomes.
How similar studies have performed: Other studies have shown promising results in reducing antimicrobial use through rapid diagnostic testing, indicating that this approach may be effective.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * History of reported fever or fever greater than 100.4◦F (38◦C) with duration of illness up to 7 days * Duration of fever less than or equal to 7 days * Can connect with mobile phone for follow up Exclusion Criteria: * Child younger than 1 year * Main complaint being trauma or injury * Symptoms requiring hospital referral * Impaired consciousness * Inability to take oral medication * Convulsions * Confirmed malaria * Confirmed urinary tract infection * Local skin infection * Dental abscess or infection * Suspicion of tuberculosis * Any symptom other than fever present for more than 14 days * Any bleeding such as from skin, nose and gums.
Where this trial is running
Resunga Nagarpalika, Lumbini
- Paralmi Health Post — Resunga Nagarpalika, Lumbini, Nepal (Recruiting)
Study contacts
- Principal investigator: Amit Arjyal, MBBS, DPhil — Patan Academy of Health Sciences
- Study coordinator: Amit Arjyal, MBBS, DPhil
- Email: amitarjyal@pahs.edu.np
- Phone: +9779864478329
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.