Background C-reactive protein (CRP) is an inflammatory protein used in clinical practice to identify and monitor inflammatory and infectious processes. Recent data suggest CRP might be useful in guiding antibiotic therapy discontinuation among critical care patients. This meta-analysis analyzed the benefits and risks of CRP-guided protocols to guide antibiotic therapy in hospitalized patients in comparison with standard treatment. Methods Studies were searched in four databases: CENTRAL, Medline, Embase and LILACS. The search was performed until Jan 25th, 2023. The reference lists of the articles retrieved and related review studies were hand-screened to find eligible trials that might have been missed. Primary endpoints included the duration of antibiotic therapy for the index episode of infection. The secondary endpoint was the all-cause hospital mortality and infection relapses. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Random effects were used to pool the mean differences and odds ratio of individual studies. The protocol was registered in PROSPERO (CRD42021259977). Results The search strategy retrieved 5209 titles, out of which three studies met the eligibility criteria and were included in this meta-analysis. 727 adult patients were analyzed, of whom 278 were included in the intervention group and 449 were included in the control group. 55,7% of all patients were women. Meta-analysis indicated that experimental groups (CRP-guided) had a lower duration of antibiotic therapy (days) [MMD = -1.82, 95%IC -3.23; -0.40]; with no difference in mortality [OR = 1.19 95%IC 0.67–2.12] or in the occurrence of infection relapse [OR = 3.21 95%IC 0.85–12.05]. Conclusion The use of CRP-guided protocol reduces the total amount of time required for antibiotic therapy when compared to standard protocols of treatment in hospitalized patients with acute bacterial infection. We did not observe statistical differences regarding mortality and infection relapse rates.

Background: C-reactive protein (CRP) is an acute-phase marker used in clinical practice to identify and monitor inflammatory and infectious processes. Recent data suggest that CRP might be useful in guiding antibiotic therapy discontinuation among critical care patients. This meta-analysis analyzed the benefits and risks of CRP-guided protocols to define antibiotic therapy discontinuation in hospitalized patients in comparison with standard treatment. Methods: Studies were searched in four databases: Medline, Embase, CENTRAL, and LILACS. The reference lists of the articles retrieved, and related review studies were hand-screened to find eligible trials that might have been missed. Primary endpoints included the duration of antibiotic therapy for the index episode of infection. The secondary endpoint was the all-cause hospital mortality and infection relapses. Risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Random effects were used to pool the mean differences and odds ratio of individual studies. The protocol was registered in PROSPERO (CRD42021259977).Results: The search strategy retrieved 5209 titles, out of which 03 studies met the eligibility criteria and were included in this meta-analysis. 727 patients were analyzed, of whom 278 were included in the intervention group and 449 were included in the control group. 55,7% of all patients were women. Meta-analysis indicated that experimental groups (CRP-guided) had a shorter duration of antibiotic therapy (days) [MMD= -1.82, 95%IC -3.23; -0.40], with no difference in mortality [OR =1.19 95%IC 0.67-2.12] or occurrence of infection relapse [OR =3.21 95%IC 0.85-12.05] between the two groups. Conclusion: The use of CRP-guided protocol reduced the total amount of time required for antibiotic therapy when compared to standard protocols of treatment in hospitalized patients with an acute bacterial infection. We did not observe statistical differences in mortality and infection relapse rates.

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A menopausa é a ausência consecutiva da menstruação por um período de doze meses que, em geral, ocorre entre os 45 e 55 anos. Neste período, as mulheres enfrentam sintomas desconfortáveis, como fogachos, perda da concentração, distúrbios biológicos do sono, ou até mesmo perda da memória relacionados a eventos decorrentes de alterações hormonais e sociais, sendo este último, principalmente, após o início das restrições impostas devido a COVID-19. Dessa maneira, diante de tais alterações, a terapia de reposição hormonal faz-se útil no controle das manifestações vasomotoras e urogenitais decorrentes do decréscimo de produção de esteroides ovarianos, principalmente o estradiol e a progesterona, comuns a este período.Devido às alterações hormonais vivenciadas por este público feminino, a presente revisão literária se propõe a discutir o papel do estrogênio com o protetor da gravidade da infecção provocada pelo vírus da Covid 19, SARS COV 2, somado à necessidade de isolamento em virtude da disseminação do vírus da COVID-19.