C-reactive protein testing in primary care for acute respiratory infections: a cost-effective strategy to mitigate antimicrobial resistance across different income settings

The 2024 UN General Assembly High-Level Meeting on Antimicrobial Resistance (AMR) highlights the urgent need to address this global health threat. Primary care, where most antimicrobial use occurs, should be a key focus for intervention. C-reactive protein (CRP) testing can quickly determine if respiratory infections are self-limiting, ruling out the need for antibiotics. This aligns with WHO’s people-centred strategy to address AMR and Sustainable Development Goal 3.8. Low-cost devices can make CRP testing feasible in low-income and middle-income countries. However, concerns about diagnostic accuracy and the need for adequate training for healthcare workers are addressed. CRP testing can provide assurance that antibiotics can be safely withheld, despite a small proportion of patients with elevated CRP.