-----Original Message-----
From: Phillip Jordan <[log in to unmask]>
To: ACB Mailbase <[log in to unmask]>
Date: 07 July 1998 16:43
Subject: CRP
>Requests for CRP measurement have increased dramatically in recent years,
>and at the same time there has been associated expectations of faster
>turn-around and availability. Laboratories are undoubtedly to blame in
>part for this due to the introduction of readily accessible technology, but
>the clinical indications for considered need seem to be increasing
>inexorably and are of dubious relevance to diagnosis and/or management.
>Whilst not wishing to re-invent the wheel, has anyone seen published, or
>would anyone be willing to share, local guidelines on appropriate
>indications for CRP measurement, repetition intervals, etc., which could be
>used for the benefit and education of junior medical staff, from whom
>requests originate.
>
>Phillip Jordan
>Clinical Scientist
>Royal Devon and Exeter Hospital
>
>
Phillip,
Since April this year we have taken over the CRP service from our
haematology department and because of the improved turnround time and 24
hour availability we have already seen a 10% increase in the the workload
that was about 18,000 requests/year. My impressions are that the level of
abuse is probably no greater than for other tests but I would agree that
some form of guidelines on its use would be welcome. The paediatricians in
particular are very pleased with the improvements in this service and the
consultants on the Admissions Unit have found it very helpful in assessing
some cases.
What I would be interested to know from others is that does a rapid CRP
service influence the use of or result in changes in antibiotic therapy. Is
it not also time for the archaic ESR test to be abandoned in favour of CRP
as it is often requested at the same time?
Dr Roy Fisher
Consultant Biochemist
Royal Cornwall Hospital
Truro
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