The Clinical Significance of Serum C-reactive Protein in Patients with Acute Uncomplicated Pyelonephritis

Chung, Hong; Kim, Tong Wook; Lee, Chang Hoon; Kim, Hong Sup

Abstract

PURPOSE
To evaluate the predicted results of treatment and to decide the time of using parenteral antibiotics to oral medication in Acute Uncomplicated Pyelonephritis, the serum C-reactive protein (CRP), WBC counts and body temperature (BT) were compared.
MATERIALS AND METHODS
Between May 2003 and August 2004, 59 female patients with acute uncomplicated pyelonephritis were enrolled. The serum CRP, WBC counts and BT were measured on the first, third, fifth and seventh day after admission, and on the seventh day following discharge. The durations and patterns of the serum CRP, WBC counts and BT were statistically assessed after the use of parenteral antibiotics.
RESULTS
The serum CRP, WBC counts and BT were increased in all patients on the first hospital day, but only the serum CRP was statistically correlated with the clinical course, with an average level of 11.83mg/dl. After the use of parenteral antibiotics, the mean serum CRP decreased to 8.38, 4.00 and 1.92mg/dl on the third, fifth and seventh day after admission, respectively. There were no cases increased serum CRP level or recurrence of inflammation during the follow-up period. The initial serum CRP level was also correlated with the disease severity when over 15mg/dl, the longer use of parenteral antibiotics and the longer stay in hospital were needed.
CONCLUSIONS
Clinically, the level of serum CRP was a better indicator in determining the therapeutic effect of parenteral antibiotics use in patients with acute uncomplicated pyelonephritis than either the WBC counts or BT. Especially, in patients whose serum CRP level was decreased below 2.00mg/dl during the early days of the hospital stay, a decreased use of parenteral antibiotics and decreased hospital stay were observed. The initial serum CRP level was also correlated with disease severity.