Serial study of C reactive protein in neonatal septicaemia.

Hindocha, P.; Campbell, Caren; Gould, J D; Wojciechowski, Amy L.; Wood, C. B. S.

doi:10.1136/adc.59.5.435

Cited by 30 publications

(7 citation statements)

References 7 publications

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“…In contrast, some studies have indicated that serial CRP measurements is one of the most useful methods in the evaluation of therapeutic effectiveness. CRP measurements have been used to determine the timing of discontinuation of antibiotic therapy (1,(3)(4)(5)(6)(7).…”

Section: Discussionmentioning

confidence: 99%

“…Thus CRP values obtained from one measurement point must be interpreted with caution (1,2). To date, several studies have demonstrated that serial CRP measurements are useful in assessing the efficacy of antibiotic therapy and in determining the timing of discontinuation of antibiotic therapy for the infected infant (1,(3)(4)(5)(6)(7). Generally, antibiotic therapy is started in infants with risk factors for infection before infection is diagnosed.…”

mentioning

confidence: 99%

“…A laser nephelometer makes it possible to measure CRP concentration at the bedside in a short time and it requires only a small amount of serum (approximately 20 [1][2][3][4][5][6][7][8][9][10][11]. With this equipment, repeated measurements of CRP in day can be performed easily.…”

mentioning

confidence: 99%

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The usefulness of serial C‐reactive protein measurement in managing neonatal infection

Kawamura¹,

Nishida²

1995

Acta Paediatrica

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Recent advances in laboratory technology have enabled us to measure C-reactive protein with a higher sensitivity in a short period using a minimal amount of blood. Thus C-reactive protein can be measured easily several times a day. In this study, serial changes in C-reactive protein values were evaluated in 108 term and 240 preterm newborn infants with suspicion of infection, and the changing patterns of C-reactive protein values were compared with clinical outcome. For a diagnosis of infection, the negative predictive values in term and preterm infants were 99.0% and 97.8%, respectively, although the sensitivities were 61.5% and 75.0%, respectively. Antibiotic therapy was started at birth and discontinued when the changing pattern of C-reactive protein and clinical findings did not suggest infection. As a result, mean durations of administration of antibiotics in the term and preterm infants were 3 and 4 days, respectively. Recognition of the changing pattern of C-reactive protein was very useful in excluding infection and minimizing unnecessary antibiotic therapy in managing neonatal infection.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The usefulness of serial C‐reactive protein measurement in managing neonatal infection

Kawamura¹,

Nishida²

1995

Acta Paediatrica

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“…higher than those in adults at weeks 7 and II (267 ± 176 Jlg/L and 269 ±163 Jlg/L respectively) but not at week 15 (176± 165 Jlg/L). There were no differences between infants fed breastmilk and those fed on infant formulas.…”

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confidence: 98%

Enzyme Immunoassay of Lactoferrin in Newborn Term Infants: Reference Values and Influence of Diet

Scott

1989

Ann Clin Biochem

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SUMMARY. Plasma lactoferrin is an acute phase protein which may have a variety of roles in the anti-infective process. As the diagnosis of infection in infants is particularly difficult, measurement of this protein could make a useful contribution, however previous reference values for infants were unsatisfactory.A solid phase enzyme immunoassay for plasma lactoferrin which required only a small specimen of blood was established. It was linear up to 800 Jlg/L, with a recovery of between 96 and 99%, and had a between batch precision of between 10 and 15%. Using this method we have determined the level of circulating lactoferrin in term infants during the first three weeks of life to be (mean ± SD) 385 ± 113 Jlg/L which is significantly (P < 0,005) higher than that found in adults (venous plasma 122 ± 40 Jlg/ L; capillary plasma 107 ± 73 Jlg/L). Plasma lactoferrin levels were still significantly higher than those in adults at weeks 7 and II (267 ± 176 Jlg/L and 269 ±163 Jlg/L respectively) but not at week 15 (176± 165 Jlg/L). There were no differences between infants fed breastmilk and those fed on infant formulas. These findings are discussed in terms of the possible origin and role of lactoferrin in the newborn.

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“…5 Thus CRP may sufficiently reflect the individual balance between the microbes and the immune system of the neonate for monitoring the effect of antibiotic treatment and for guiding the duration of antibiotic therapy. [6][7][8] The present prospective study is undertaken to determine whether C-reactive protein (CRP) can be used as a parameter to identify the time point when antibiotic therapy can safely be discontinued in suspected bacterial infection.…”

Section: Introductionmentioning

confidence: 99%

A study on validity of C-reactive protein in deciding the duration of antibiotic therapy in suspected neonatal bacterial infection

Siddaiah

Shetty

Krishna

et al. 2017

Int J Contemp Pediatr

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Background: Neonatal septicemia is defined as generalized bacterial infection of newborns documented by positive blood culture in first four weeks of life. Objective of present study was to determine whether C-Reactive protein can be used as a parameter to identify the time point when antibiotic treatment can safely be discontinued in a defined major subgroup of neonates treated for suspected bacterial infection.Methods: A total of 50 neonates with birth weight more than 1500gms with suspected septicemia were enrolled in the prospective study. Serum CRP were determined 24-48 hours after the first dose of antibiotics. If CRP was less than 6mg/l, infants were considered unlikely to be infected and the antibiotic treatment was stopped. If CRP was more than 6mg/l, antibiotics were continued and CRP measured on alternative days in one subgroup (2a) and on seventh day in another subgroup (2b). CRP was the single decision criterion to stop the antibiotic therapy. Negative predictive value with respect to further treatment was determined.Results: Duration of antibiotic therapy could be reduced to less than seven days in 54% cases and < 72 hours in 48% cases.Conclusions: Negative predictive value of serial CRP is 100% in deciding the duration of antibiotic therapy in suspected neonatal septicemia.

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Serial study of C reactive protein in neonatal septicaemia.

Cited by 30 publications

References 7 publications

The usefulness of serial C‐reactive protein measurement in managing neonatal infection

The usefulness of serial C‐reactive protein measurement in managing neonatal infection

Enzyme Immunoassay of Lactoferrin in Newborn Term Infants: Reference Values and Influence of Diet

A study on validity of C-reactive protein in deciding the duration of antibiotic therapy in suspected neonatal bacterial infection

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