Table 3.

Strategies to reduce antibiotic prescribing in LRTIs.

Quantitative CRP POCT	Clinical assessment remains the primary decision-driver in antibiotic prescription (and its reduction) in LRTIs Supports differentiation of viral and self-limiting bacterial infections from severe bacterial infections in patients presenting with symptoms of LRTI Proven add-on to reduce antibiotic prescribing in LRTIs
Semi-quantitative CRP POCT	Only useful if more than 1–2 cut-offs are provided, e.g., 20–40-100 mg/L Data from studies with quantitative CRP POC tests are not generally transferrable to semi-quantitative tests Resource-limited settings could benefit because of lower costs and increased availability
Delayed prescribing	Not optimal as antibiotics are either needed at the time point of the patient visit or not May be useful for specific patients Should be combined with improved communication Not useful in countries where awareness of bacterial AMR is low and patients’ expectance for antibiotics is high
Communication training and tools	Impactful communication is key, but takes time Needs to be supported by communication tools (online information, patient leaflets, awareness campaigns) Training on communication techniques can be beneficial but should not be prescriptive
Procalcitonin (POCT)	Not well evaluated and not sensitive in the primary care setting More expensive than CRP testing Not generally available
Influenza A and B POCT	Should be used only during the influenza season in selective patients
Strep A POCT	Should be used only when in doubt Useful in countries where prescribing for upper RTIs is high