Original Articles
To study the role of C-reactive protein in determining the appropriate length of antibiotic treatment for newborn bacterial infections | |
Dr. Sanket Tyagi, Dr. Rohit Bharadwaj, Dr. Mayank Dixit | |
Aim: To study the role of C-reactive protein in determining the appropriate length of antibiotic treatment for newborn bacterial infections. Material and method: 80 neonates admitted at paediatric ward were studied. Neonates <28 days of life having birth weight more than 1500 grams with suspected septicaemia were included in the study. Neonates undergone surgery due to wound infection Neonates diagnosed as meningitis (because it requires longer treatment of antibiotics) were excluded from study. After admission blood culture and sensitivity, Routine blood investigations, urine culture and sensitivity, chest x-ray, CRP were done. CRP was estimated within 24- 48 hours of admission. Then neonates were classified as per the levels of CRP serum levels. Neonates were kept up to 48 hours after stopping the antibiotics to observe the recurrence of clinical features of septicaemia. Results: Neonates were categorized into three groups based on their CRP levels at admission: <10 mg/L, 10-20 mg/L, and >20 mg/L. The largest group consisted of neonates with CRP levels between 10-20 mg/L (37.5%), followed by those with CRP levels <10 mg/L (31.25%), and those with CRP levels >20 mg/L (31.25%).The duration of antibiotic therapy varied according to the CRP levels at admission. Neonates with CRP levels <10 mg/L required an average of 5 days of antibiotic therapy, those with CRP levels between 10-20 mg/L required an average of 7 days, and those with CRP levels >20 mg/L required an average of 10 days. This indicates a correlation between higher CRP levels and longer durations of antibiotic therapy.The negative predictive value (NPV) of CRP levels was calculated to determine the effectiveness of CRP as a parameter for guiding the duration of antibiotic therapy. Neonates with CRP levels <10 mg/L had the highest NPV (96%), indicating that these neonates had the lowest risk of requiring further antibiotic treatment. The NPV for neonates with CRP levels between 10-20 mg/L was 93%, while it was 80% for those with CRP levels >20 mg/L. This shows that lower CRP levels are strong indicators of a successful course of antibiotic therapy without the need for further treatment. Conclusion: In conclusion, our study demonstrates the significant role of CRP levels in guiding the duration of antibiotic therapy in neonatal bacterial infections. The results are consistent with existing literature and reinforce the utility of CRP as a reliable biomarker for predicting treatment outcomes and recurrence risks. Further research could explore the integration of CRP levels with other biomarkers to enhance the precision of antibiotic therapy duration in neonates. |
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