All issues > Volume 41(7); 1998

Original Article

J Korean Pediatr Soc. 1998;41(7):901-908. Published online July 15, 1998.

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

Jae Il JI Yoo¹, Jin Hwa JH Jeong¹, Jeong Ho JH Lee¹, Jong Dae JD Cho¹

¹Department of Pediatrics, Maryknoll Hospital, Pusan, Korea

Correspondence Jae Il JI Yoo ,Email: 1

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.

Keywords :C-reactive protein, Neonatal bacterial infection