Studies show that POC CRP testing is accurate, reliable, and user-friendly in children [
26,
39]. The study of Jones et al. [
40] found that GPs would like to use POC CRP testing if strong evidence of the impact on patient care is available. Increased levels of POC CRP can be associated with serious infections, however we do not recommend physicians to solely base their clinical decision on POC CRP. Low POC CRP levels do not necessarily rule out serious infections. However, when combined with a clinical decision tool its potential increases. A previous analysis of our study [
4], combining POC CRP with a clinical decision tool, shows that in children with increased risk (presenting with breathlessness, temperature ≥40 °C, diarrhoea in children aged 12–30 months or clinician’s gut feeling), CRP levels < 5 mg/L can safely rule out serious infection. In adults multiple studies show that POC CRP testing has a positive effect on the antibiotic prescribing rate [
23,
41‐
43]. POC CRP testing is therefore now recommended in NICE and Dutch guidelines for acute cough in adults [
44,
45]. For children the situation remains somewhat unclear, as clear cut-off values of CRP are lacking and in comparable health care settings, no significant reduction of the prescribing rate is seen [
10,
28,
46]. A study in Vietnam, consisting of 1000 children, did show a significant effect of POC CRP testing on the antibiotic prescribing rate [
47] We notice that the prescribing rate in both groups, POC CRP testing and routine care, was high, respectively 68% and 77%. This might explain the effect of POC CRP testing, as studies show that in GPs who already have a low antibiotic prescribing rate, POC CRP testing does not reduce it [
48]. A more recent study of Lemiengre et al. [
10] showed that systematic POC CRP without guidance in comparison to usual care did not influence antibiotic prescribing in children with acute non-severe infections in primary care, and a Norwegian study [
49], which took place in out-of-hours services, found that pre-consultation screening with CRP in children with fever and/or respiratory symptoms did not significantly affect the prescription of antibiotics or referral to hospital. On the other hand, a review of Verbakel et al. [
8] stated that POC CRP test in ambulatory care accompanied by clinical guidance can reduce the immediate antibiotic prescribing rate, and another study showed that normal CRP levels discourage immediate antibiotic prescribing, even when EBM practice guidelines advise differently, and elevated CRP levels did not increase antibiotic prescribing [
21]. Currently the EPI-centre team, led by Prof. Dr. Jan Verbakel, is performing a multicentre, cluster-randomized trial in ambulatory care, in which the impact of a diagnostic algorithm, including clinically guided POC CRP testing and safety netting advice on antibiotic prescribing rate and the further management of acutely ill children is investigated [
50].