Oral Antibiotics for Treating Children With Community-Acquired Pneumonia Complicated by Empyema

2019 ◽  
Vol 58 (13) ◽  
pp. 1401-1408 ◽  
Author(s):  
Lauren E. Kushner ◽  
Delma J. Nieves ◽  
Stephanie Osborne ◽  
Hita Vora ◽  
Antonio Arrieta ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Treatment Success ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Length Of Treatment ◽  
Erythrocyte Sedimentation ◽  
End Of Treatment ◽  
Wbc Count ◽  
Serial Measurements

No consensus exists on management of children with community-acquired pneumonia complicated by empyema (CAP-Em). We evaluated outpatient oral (O-Abx) compared with parenteral antibiotics (OPAT) in children with CAP-Em. We also evaluated inflammatory markers to guide length of treatment. We conducted a retrospective cohort study of patients discharged (2006-2016) with CAP-Em. Primary outcome measured was treatment success (no change in antibiotics or readmission to hospital for treatment of CAP-Em). White blood cell (WBC) count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) serial measurements were identified. Success was achieved in 133/144 (92.4%) O-Abx and 7/12 (58%) OPAT patients ( P = .0031). WBC and CRP decreased early; and ESR increased initially (admit and switch to O-Abx) and decreased by end of treatment. O-Abx is the modality of choice for treatment of CAP-Em after hospital discharge. WBC and CRP are useful to monitor success of O-Abx switch; and ESR provides guidance for length of treatment.

scholarly journals 1249. Images vs. C-Reactive Protein Follow-up of Patients with Organ/space Surgical Site Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S449-S449
Author(s):  
Natalia Garcia Allende ◽  
Cristina Freuler ◽  
Ana Victoria Sanchez ◽  
Cecilia Ezcurra ◽  
Micaela Mayer Wolf ◽  
...  
Keyword(s):  
Imaging Study ◽  
Surgical Site Infections ◽  
Antimicrobial Treatment ◽  
Average Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
End Of Treatment ◽  
Intra Abdominal Infection

Abstract Background End-of-treatment images of infections after intra-abdominal infection could increase costs. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are used to define and predict the evolution of infectious diseases. The aim of this study was to describe clinical outcomes of adult patients with end-of-treatment images or CRP and ESR follow-up, during treatment of organ/space (OS) (intra-abdominal) surgical site infection (SSI). Methods Observational retrospective cohort. Hospitalized patients older than 16 years were included, who developed OS SSI after abdominal surgery, in a general hospital, from June 2014 to June 2018. Population variables: age, gender, comorbidities (cancer, diabetes mellitus, cirrhosis, chronic renal failure, tobacco, immunosuppressants, Charlson score and obesity), ESR, quantitative CRP, imaging study (tomography (CT)/ ultrasound), type of drainage route (surgical, percutaneous). Outcomes variables: antibiotic patient-days, time to infection (TTI), CRP and ESR at the time of diagnosis (TD) and at the end of treatment (TET), rate of relapsing infection. Statistical analysis: Description of variables sort by patients under images follow-up and patients under CRP and ESR follow-up. Fisher test of relapsing infection was calculated between groups. Results Included: 76 patients. Twenty-six were followed with CT or ultrasound and 50 were followed with CRP and ESR. Forty women, with a mean age of 55 years (19–91) and an average score of the Charlson of 3.64 (0–10). Forty patients had cancer before surgery (52.63%). Microbiological diagnosis: 70/76 patients, the majority was polymicrobial. Average of antibiotics patient-days was 24.4 days (14 days of intravenous therapy). TTI: 8.65 days. Average CRP at the TD was 87.5 mg/L and 17.5 mg/L at TET. No differences in ESR values (31.9 mm to 33.5 mm). Percutaneous drainage: 46 patients. Surgical procedure: 27. Relapsing infection: 11,5% in images group vs. 4% in no images group; P = 0.33. Conclusion Quantitative CRP monitoring was useful to guide the duration of antimicrobial treatment. No differences of relapsing infection between groups was found. Disclosures All authors: No reported disclosures.

Utility of procalcitonin for differentiating cryptogenic organising pneumonia from community-acquired pneumonia

2019 ◽  
Vol 57 (10) ◽  
pp. 1632-1637 ◽  
Author(s):  
Akihiro Ito ◽  
Tadashi Ishida ◽  
Hiromasa Tachibana ◽  
Machiko Arita ◽  
Akio Yamazaki ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Roc Curve Analysis ◽  
Histopathological Findings ◽  
Reactive Protein ◽  
Auc Value ◽  
Wbc Count

Abstract Background This study aimed to investigate the usefulness of inflammatory biomarkers such as white blood cell (WBC) count, C-reactive protein (CRP) and procalcitonin (PCT) for differentiating cryptogenic organising pneumonia (COP) from community-acquired pneumonia (CAP). Methods COP patients hospitalised in Kurashiki Central Hospital between January 2010 and December 2017 whose WBC counts and CRP and PCT levels were measured were investigated retrospectively, and their results were compared with those of hospitalised CAP patients who were prospectively enrolled between October 2010 and November 2017. Definite COP was defined by specific histopathological findings, and possible COP was defined as a consolidation shadow on chest computed tomography and lymphocyte dominance in bronchoalveolar lavage fluid in the absence of specific histopathological findings or lung specimens. The discriminatory abilities of WBC counts, CRP and PCT were evaluated by receiver operating characteristic (ROC) curve analysis. Results There were 56 patients in the entire COP group, 35 (61.4%) with definite COP, and 914 CAP patients. All three biomarkers were significantly lower in COP than in CAP. The AUC value of PCT in all COP patients was 0.79, significantly higher than of both CRP (AUC 0.59, p < 0.001) and WBC (AUC 0.69, p = 0.048). In definite COP patients, the AUC value of PCT was 0.79, which was also significantly higher than of both WBC (AUC 0.64, p = 0.006) and CRP (AUC 0.64, p = 0.001). Conclusions PCT is a more useful biomarker for differentiating COP from CAP than WBC count or CRP. However, PCT should be used as an adjunct to clinical presentation and radiological findings.

Serum C-Reactive Protein, Erythrocyte Sedimentation Rate, and White Blood Cell Count in Acute Hematogenous Osteomyelitis of Children

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Leila Unkila-Kallio ◽  
Markku J.T. Kallio ◽  
Heikki Peltola ◽  
Juhani Eskola
Keyword(s):  
Blood Cell ◽  
Mean Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
The Mean ◽  
Wbc Count ◽  
Time Of Admission

Objective. The aim of this prospective study was to compare the clinical value of the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC) count in diagnosis and follow-up of acute hematogenous osteomyelitis in children. Design. Forty-four children aged 2 weeks to 14 years with bacteriologically confirmed acute hematogenous osteomyelitis were examined. Staphylococcus aureus was responsible in 39 cases (89%), Haemophilus influenzae type b in 3 cases (7%), pneumococcus in 1 case (2%), and a microaerophilic streptococcus in 1 case (2%). ESR was measured at the time of admission and on days 3, 5, 7, 10, 14, 19, and 29 of treatment, and CRP was measured on the same days as ESR but also on days 2, 9, 12, 17, and 23. WBC count was examined at the time of admission and on days 5, 10, 19, and 29. Results. ESR was elevated (≥20 mm/h) initially in 92% of the cases; the mean value was 45 mm/h, and the peak values (mean 58 mm/h) were reached on days 3 to 5. After this the levels slowly returned to normal in approximately 3 weeks (mean 18 days). CRP was elevated (&gt;19 mg/L) at the time of admission in 98% of the cases, the mean value being 71 mg/L. The peak CRP value was reached on day 2 (mean 83 mg/L). The decrease was very rapid, normal values being reached within a week (mean 6.9 days). The WBC count was a poor indicator of acute hematogenous osteomyelitis, since only 35% of the children had leukocytosis (WBCs &gt; 12 x 109/L) at the time of admission. Conclusions. In patients with acute hematogenous osteomyelitis, CRP increased and especially decreased significantly faster than ESR, reflecting the effectiveness of the therapy given and predicting recovery more sensitively than ESR or WBC count.

Serum Procalcitonin and C-Reactive Protein Levels as Indicators of Treatment Success in Patients With Community-Acquired Pneumonia

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 920A
Author(s):  
Abdullah Sayiner ◽  
M. Sezai Tasbakan ◽  
Canan Gunduz ◽  
Aykut Cilli ◽  
Burcu Celenk ◽  
...  
Keyword(s):  
Treatment Success ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Low-Field MR Imaging for the Assessment of Therapy Response in Musculoskeletal Infections

1995 ◽  
Vol 36 (3) ◽  
pp. 220-227 ◽  
Author(s):  
I. Hovi ◽  
M. Valtonen ◽  
O. Korhola ◽  
P. Hekali
Keyword(s):  
Mr Imaging ◽  
Therapy Response ◽  
C Reactive Protein ◽  
Musculoskeletal Infection ◽  
Reactive Protein ◽  
Low Field ◽  
Erythrocyte Sedimentation ◽  
Follow Up Studies ◽  
Wbc Count

Fifty-one patients with musculoskeletal infection were imaged by repeated MR imaging at ultra low-field and low-field strength. Soft-tissue infection, osteomyelitis, septic arthritis, and spondylitis were studied. The MR finding was scored according to the signal intensity (SI) on T2-weighted images (T2WI), and correlated with the values of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and peripheral white blood cell (WBC) count. There was a positive correlation between the MR score and both CRP and ESR, but no correlation between MR score and WBC. The MR score between the follow-up studies decreased significantly in accordance with clinical reconstitution. The MR finding according to the SI on T2WIs corresponded better to disease activity than did the CRP or ESR.

Diagnostic value of procalcitonin, erythrocyte sedimentation rate (ESR), quantitative C-reactive protein (CRP) and clinical findings associated with osteomyelitis in patients with diabetic foot

2021 ◽  
pp. 1-7
Author(s):  
Zahra Soleimani ◽  
Fatemeh Amighi ◽  
Zarichehr Vakili ◽  
Mansooreh Momen-Heravi ◽  
Seyyed Alireza Moravveji
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Roc Curve ◽  
Diabetic Foot ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Diabetic Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation

BACKGROUND: The diagnosis of osteomyelitis is a key step of diabetic foot management. Procalcitonin (PCT) is a novel infection marker. This study aimed to investigate the diagnostic value of procalcitonin and other conventional infection markers and clinical findings in diagnosis of osteomyelitis in diabetic foot patients. METHODS AND MATERIALS: This diagnostic value study was carried out on ninety patients with diabetic infected foot ulcers admitted in Kashan Beheshti Hospital, 2016. After obtaining consent, 10 cc blood sample was taken for measuring serum PCT, CBC, ESR, CRP and FBS. Clinical characteristics of the wounds were noted. Magnetic resonance imaging of the foot was performed in all patients to diagnose osteomyelitis. All statistical analyses were done with the use of SPSS-16. RESULTS: PCT levels were 0.13 ± 0.02 ng/mili patients with osteomyelitis (n= 45) and 0.04 ± 0.02 ng/ml in patients without osteomyelitis (n= 45). PCT, Erythrocyte sedimentation rate and C-reactive protein was found significantly higher in patients with osteomyelitis (p< 0.001). The ROC curve was calculated for PCT. The area under the ROC curve for infection identification was 1 (p< 0.001). The best cut-off value for PCT was 0.085 ng/ml. Sensitivity, specificity, and positive and negative predictive values were 100%, 97.8%,97.8% and 100%, respectively. CONCLUSION: In this group of patients, PCT was useful to discriminate patients with bone infection. Also, Erythrocyte sedimentation rate and C-reactive protein can be used as a marker of osteomyelitis in diabetic patients.

scholarly journals Serum C-reactive protein and WBC count in conservatively and operatively managed bacterial spondylodiscitis

2020 ◽  
Vol 29 (1) ◽  
pp. 230949902096829
Author(s):  
Christina van Gerven ◽  
Kevin Eid ◽  
Tobias Krüger ◽  
Michael Fell ◽  
Daniel Kendoff ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Serum Levels ◽  
Blood Chemistry ◽  
Nonoperative Treatment ◽  
C Reactive Protein ◽  
Disc Disease ◽  
Reactive Protein ◽  
Postoperative Serum ◽  
Wbc Count ◽  
And Control

Purpose: C-reactive protein (CRP) and white blood cell (WBC) count are routine blood chemistry parameters in monitoring infection. Little is known about the natural history of their serum levels in conservative and operative spondylodiscitis treatment. Methods: Pre- and postoperative serum levels of CRP and WBC count in 145 patients with spondylodiscitis were retrospectively assessed. One hundred and four patients were treated by debridement, spondylodesis, and an antibiotic regime, 41 only with a brace and antibiotics. The results of the surgical group were compared to 156 patients fused for degenerative disc disease (DDD). Results: Surgery had a significant effect on peak postoperative CRP levels. In surgically managed patients, CRP peaked at 2–3 days after surgery (spondylodiscitis: pre-OP: 90 mg/dl vs. post-OP days 2–3: 146 mg/dl; DDD: 9 mg/dl vs. 141 mg/dl; p < 0.001), followed by a sharp decline. Although values were higher for spondylodiscitis patients, dynamics of CRP values were similar in both groups. Nonoperative treatment showed a slower decline. Surgically managed spondylodiscitis showed a higher success rate in identifying bacteria. Specific antibiotic treatment led to a more predictable decline of CRP values. WBC did not show an interpretable profile. Conclusion: CRP is a predictable serum parameter in patients with spondylodiscitis. WBC count is unspecific. Initial CRP increase after surgery is of little value in monitoring infection. A preoperative CRP value, and control once during the first 3 days after surgery is sufficient. Closer monitoring should then be continued. Should a decline not be observed, therapy needs to be scrutinized, antibiotic treatment reassessed, and concomitant infection contemplated.

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