Reduction of Unnecessary Antibiotic Therapy in Newborn Infants Using Interleukin-8 and C-Reactive Protein as Markers of Bacterial Infections

PEDIATRICS ◽  
1999 ◽  
Vol 104 (3) ◽  
pp. 447-453 ◽  
Author(s):  
Axel R. Franz ◽  
Gerald Steinbach ◽  
Martina Kron ◽  
Frank Pohlandt
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infections ◽  
Newborn Infants ◽  
Interleukin 8 ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals C-reactive protein and procalcitonin for antimicrobial stewardship in COVID-19

Infection ◽  
2021 ◽  
Author(s):  
Isabell Pink ◽  
David Raupach ◽  
Jan Fuge ◽  
Ralf-Peter Vonberg ◽  
Marius M. Hoeper ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Roc Analysis ◽  
Secondary Infection ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Secondary Bacterial Infection ◽  
Reactive Protein ◽  
Tract Infections

Abstract Purpose Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) has spread around the world. Differentiation between pure viral COVID-19 pneumonia and secondary infection can be challenging. In patients with elevated C-reactive protein (CRP) on admission physicians often decide to prescribe antibiotic therapy. However, overuse of anti-infective therapy in the pandemic should be avoided to prevent increasing antimicrobial resistance. Procalcitonin (PCT) and CRP have proven useful in other lower respiratory tract infections and might help to differentiate between pure viral or secondary infection. Methods We performed a retrospective study of patients admitted with COVID-19 between 6th March and 30th October 2020. Patient background, clinical course, laboratory findings with focus on PCT and CRP levels and microbiology results were evaluated. Patients with and without secondary bacterial infection in relation to PCT and CRP were compared. Using receiver operating characteristic (ROC) analysis, the best discriminating cut-off value of PCT and CRP with the corresponding sensitivity and specificity was calculated. Results Out of 99 inpatients (52 ICU, 47 Non-ICU) with COVID-19, 32 (32%) presented with secondary bacterial infection during hospitalization. Patients with secondary bacterial infection had higher PCT (0.4 versus 0.1 ng/mL; p = 0.016) and CRP (131 versus 73 mg/L; p = 0.001) levels at admission and during the hospital stay (2.9 versus 0.1 ng/mL; p < 0.001 resp. 293 versus 94 mg/L; p < 0.001). The majority of patients on general ward had no secondary bacterial infection (93%). More than half of patients admitted to the ICU developed secondary bacterial infection (56%). ROC analysis of highest PCT resp. CRP and secondary infection yielded AUCs of 0.88 (p < 0.001) resp. 0.86 (p < 0.001) for the entire cohort. With a PCT cut-off value at 0.55 ng/mL, the sensitivity was 91% with a specificity of 81%; a CRP cut-off value at 172 mg/L yielded a sensitivity of 81% with a specificity of 76%. Conclusion PCT and CRP measurement on admission and during the course of the disease in patients with COVID-19 may be helpful in identifying secondary bacterial infections and guiding the use of antibiotic therapy.

scholarly journals COMPARISON OF PRESEPSIN, PROCALCITONIN, INTERLEUKIN-8 AND C-REACTIVE PROTEIN IN PREDICTING BACTERAEMIA IN FEBRILE NEUTROPENIC ADULT PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES

2019 ◽  
Vol 11 (1) ◽  
pp. e2019047 ◽  
Author(s):  
Irena Kostic ◽  
Carmela Gurrieri ◽  
Elisa Piva ◽  
Gianpietro Semenzato ◽  
Mario Plebani ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Bacterial Infections ◽  
Area Under The Curve ◽  
Interleukin 8 ◽  
Adult Patients ◽  
Haematological Malignancies ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Life Threatening ◽  
Better Than

Bacterial infections represent life-threatening complications in patients with febrile neutropenia (FN). Biomarkers of infections may help to differentiate bacteraemia from non-bacteraemia FN. We aimed to evaluate the utility of procalcitonin (PCT), presepsin (PS), C-reactive protein (CRP) and interleukin-8 (IL-8) as biomarkers of bacteraemia in adult FN patients with haematological malignancies. Thirty-six FN episodes experienced by 28 oncohematological patients were considered. 11 out of 36 episodes were classified as bacteraemia. PCT was the best biomarker to predict bacteraemia with area under the curve (AUC) ROC of 0,9; while the most sensitive was IL-8 (90,9%) with AUC ROC of 0,88. All patients with PCT concentrations above 1,6 μg/l had bacteraemia. Patients with IL-8 concentrations > 170 pg/ml or PS concentrations superior then 410 pg/ml had 40 times and 24 times higher risk for bacteraemia, respectively. PCT remains better than IL-8 and PS in predicting bacteraemia in adult hematological patients with FN.

scholarly journals Monitoring Antibiotics and Inflammatory Markers in Human Blood: Impact in Choice of Antibiotic Therapy and Used Methods

2019 ◽  
Author(s):  
Anna N. Berlina ◽  
Anatoly V. Zherdev ◽  
Boris B. Dzantiev
Keyword(s):  
Antibiotic Therapy ◽  
Inflammatory Markers ◽  
Bacterial Infections ◽  
Comparative Assessment ◽  
Modern World ◽  
Pathogenic Microorganisms ◽  
C Reactive Protein ◽  
Basic Principles ◽  
Reactive Protein ◽  
Antibiotic Drugs

In the modern world, the problem of antibiotic therapy is acute. Despite the diversity of existing antibiotic drugs, their efficacy decreases as new, resistant forms of pathogenic microorganisms emerge. It is extremely difficult to control such processes and even more difficult to treat severe bacterial infections. In such situations, an individual approach to each patient is required and physicians need parameters to estimate the efficacy of antibiotic therapy. This review discusses the significance of monitoring the content of antibiotics in the blood for this purpose, in combination with the content of inflammatory markers, such as C-reactive protein and procalcitonin. The basic principles of antibiotic therapy, and factors in the resistance of microorganisms to antibiotics, are examined. Approaches to assess the efficacy of antibiotic therapy, as well as methods to detect antibiotics and inflammatory markers in the blood of patients, and comparative assessment of their capabilities and limitations, are described.

scholarly journals Biomarkers of infection in the optimization of antibacterial therapy: justified expectations

2020 ◽  
pp. 175-187
Author(s):  
Vladimir V. Kulabukhov ◽  
А.К. Shabanov ◽  
Irina V. Andreeva ◽  
Оlga U. Stetsiouk ◽  
V.А. Andreev
Keyword(s):  
Antibiotic Therapy ◽  
Continuous Improvement ◽  
Bacterial Infections ◽  
Response To Therapy ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Serious Bacterial Infections ◽  
Time Point

Despite the continuous improvement of approaches to antimicrobial therapy and the emergence of new highly effective antibiotics, severe bacterial infections being a significant cause of morbidity and mortality remain a top of mind issue for clinicians. Immediate initiation of the effective antibiotic therapy is an essential component of the successful treatment of serious bacterial infections, and therefore, special attention should be paid to the timely diagnosis. Measurements of biomarkers of inflammation (C-reactive protein, procalcitonin, presepsin, proadrenomedullin) in combination with clinical evaluation are important at first for the diagnosis of bacterial infection, and after that these can help to assess the clinical response to therapy and determine the time-point of antibiotics withdrawal. This review presents the characteristics of the main markers of inflammation, discusses the situations when determination of biomarkers is appropriate, and also provides modern clinical recommendations and algorithms regarding the use of these diagnostic markers in the management of patients with bacterial infections.

scholarly journals Monitoring Antibiotics and Inflammatory Markers in Human Blood: Impact in Choice of Antibiotic Therapy and Used Methods

2019 ◽  
Author(s):  
Anna N. Berlina ◽  
Anatoly V. Zherdev ◽  
Boris B. Dzantiev
Keyword(s):  
Antibiotic Therapy ◽  
Inflammatory Markers ◽  
Bacterial Infections ◽  
Comparative Assessment ◽  
Modern World ◽  
Pathogenic Microorganisms ◽  
C Reactive Protein ◽  
Basic Principles ◽  
Reactive Protein ◽  
Antibiotic Drugs

In the modern world, the problem of antibiotic therapy is acute. Despite the diversity of existing antibiotic drugs, their efficacy decreases as new, resistant forms of pathogenic microorganisms emerge. It is extremely difficult to control such processes and even more difficult to treat severe bacterial infections. In such situations, an individual approach to each patient is required and physicians need parameters to estimate the efficacy of antibiotic therapy. This review discusses the significance of monitoring the content of antibiotics in the blood for this purpose, in combination with the content of inflammatory markers, such as C-reactive protein and procalcitonin. The basic principles of antibiotic therapy, and factors in the resistance of microorganisms to antibiotics, are examined. Approaches to assess the efficacy of antibiotic therapy, as well as methods to detect antibiotics and inflammatory markers in the blood of patients, and comparative assessment of their capabilities and limitations, are described.

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