Point-of-Care Biomarkers to Guide Antibiotic Prescription for Acute Febrile Illness in Sub-Saharan Africa: Promises and Caveats.

Abstract

Empiric malaria treatment in Sub-Saharan Africa has significantly decreased with the scaling-up of malaria rapid diagnostic tests; this coincided with a pronounced increase in empiric antibiotic prescriptions. In high-income countries, guidance for antibiotic prescriptions using biomarkers such as C-reactive protein (CRP) and procalcitonin (PCT) has reduced antibiotic use while safe-guarding patient safety. Importantly, several low-cost point-of-care CRP/PCT tests are currently available. However, only a few studies on the role of CRP/PCT in differentiating bacterial vs viral infections in acute febrile illness have been conducted in Sub-Saharan Africa. Studies from Central and West Africa (most of which is malaria-endemic) are particularly scarce, and only 1 has included adults. The evidence base for point-of-care use of CRP/PCT biomarkers in acute fever in Sub-Saharan Africa should be urgently built. Before engaging in clinical trials to assess clinical impact, pilot studies should be conducted to address key knowledge gaps including recommended CRP/PCT cutoff values and the effect of malaria coinfection.

• Authors: Johan van Griensven, Lieselotte Cnops, Anja De Weggheleire, Steven Declercq, Emmanuel Bottieau
• Journal: Open forum infectious diseases (Open Forum Infect Dis) Vol. 7 Issue 8 Pg. ofaa260 (Aug 2020) ISSN: 2328-8957 [Print] United States
• PMID: 32818139 (Publication Type: Journal Article, Review)
• Copyright: © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.