Effects of C-reactive protein rapid testing and communication skills training on antibiotic prescribing for acute cough. A cluster factorial randomised controlled trial

IntroductionOveruse of antibiotics has contributed to the development of antimicrobial resistance, with the highest burden being in low-resource settings1. It has been shown that most antibiotics are prescribed in primary care settings and that acute lower respiratory tract infections (LRTIs) represent one of the most common indications for their prescription2, despite the slight benefit obtained from their prescription3.Different interventions have been evaluated in order to reduce the antibiotic consumption. An illness-focused approach seeks to emphasize a patient-centred management targeting at understanding the whole patient and sharing decisions, aligning decisions with patients’ wants, needs, and preferences rather than making an accurate diagnosis4. A disease-focused approach, on the other hand, seeks to improve diagnosis and the limited value of medical history and physical examination in differentiating between serious from self-limiting LRTIs, identifying those situations in...