J Korean Pediatr Soc.  1998 Jul;41(7):901-908.

C-Reactive Protein and Duration of Antibiotic Therapy in Neonatal Bacterial Infection

• Yoo JI
• Jeong JH
• Lee JH
• Cho JD

Abstract

PURPOSE: To determine whether C-reactive protein (CRP) can be used as a parameter to assess the safety of discontinuing antibiotic therapy and allows a shorter course of therapy in neonates treated for suspected bacterial infection.
METHODS
We have experienced 193 cases of suspected neonatal bacterial infection at Pusan Maryknoll Hospital. CRP levels were measured daily by immunonephelometry. Infants with initial CRP levels less than 0.8mg/dL were considered unlikely to be infected, and antibiotic therapy was stopped (group A; n=82). If three daily serial CRP levels were less than 0.8mg/dL, antibiotics were discontinued (group B; n=51). Sixty cases were treated for at least 7 days irrespective of CRP results (group C; n=60), and relapse rates of bacterial infection were compared between the three groups within one month after discharge.
RESULTS
Within the one month follow-up period, two infants (2.4%) in group A, one infant (1.3%) in group B, two infants (3.3%) in group C received antibiotics for possible relapse of bacterial infection. The relapse rate in these groups was very low and frequency of a second course of antibiotic therapy between these groups was not different.
CONCLUSION
These data allow considerably shorter courses of antibiotic therapy, safe discontinuation by three serial CRP measurement and show that CRP can be a key parameter for guiding the duration of antibiotic treatment. In addition, it would cut the length and cost of hospital stays and diminish the side effects of parenteral antibiotics.

Keyword

C-reactive protein; Neonatal bacterial infection

MeSH Terms

Anti-Bacterial Agents
Bacterial Infections*
Busan
C-Reactive Protein*
Follow-Up Studies
Humans
Infant
Infant, Newborn
Length of Stay
Recurrence
Anti-Bacterial Agents
C-Reactive Protein