Point-of-care C-reactive protein measurement by community health workers safely reduces antimicrobial use among children with respiratory illness: results from a stepped wedge cluster-randomized trial in rural Uganda

Authors: Emily J. Ciccone, Di Hu, John S. Preisser, Caitlin A Cassidy, Lydia Kabugho, Baguma Emmanuel, Georget Kibaba, Fred Mwebembezi, Jonathan J Juliano, Edgar M Mulogo, Ross M Boyce

This study investigated the impact of using C-reaction protein (CRP) measurement by community health workers (CHWs) on antibiotic use for children under 5 with febrile acute respiratory illness (ARI) in rural Uganda. In a randomized trial, CHWs used either the standard Integrated Community Care Management (iCCM) protocol or a protocol incorporating CRP measurement. Results showed a significant reduction in antibiotic use with CRP measurement, without worsening clinical outcomes. Incorporating CRP measurement into CHW protocols can improve antibiotic stewardship in resource-constrained settings.