Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 381
About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Advertise Login 
Year : 2018  |  Volume : 7  |  Issue : 3  |  Page : 146-150

Use of a single C-reactive protein level in decision-making during neonatal sepsis evaluation

1 Department of Pediatrics, Division of Neonatology, Albany Medical Center, Albany, NY, USA
2 Department of Medical Education, Albany Medical College, Albany, NY, USA
3 Department of Pediatrics, Division of Infectious Diseases, Albany Medical Center, Albany, NY, USA

Correspondence Address:
Dr. Rubia Khalak
Department of Pediatrics, Division of Neonatology, Albany Medical Center, MC.101, 43 New Scotland Avenue, Albany, NY 12208
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcn.JCN_32_18

Rights and Permissions

Background: Use of a single C-reactive protein (CRP) level has been studied in the pediatric population, but limited information is available for the neonatal, particularly Neonatal Intensive Care Unit (NICU) infants. Objective: The objective of this study is to determine if a single CRP level in the context of other laboratory and clinical parameters, can assist in decision-making for antibiotic management. Materials and Methods: We reviewed the medical records of infants admitted to a large regional perinatal center NICU over a 2-year period. Infants in whom a CRP level had been measured were divided into sepsis-treated group if antibiotic therapy was instituted for ≥7 days or the no sepsis group if antibiotics were discontinued after 48 h. Characteristics of delivery, general characteristics of the infant and data at the time of sepsis evaluation were collected. This was a powered study to detect at least 10% difference in the proportion of those with CRP <8 mg/L versus elevated CRP levels. Results: There were 87 infants with CRP levels in the sepsis-treated group and 106 infants in the no sepsis group. Infants in the sepsis group had a significantly lower gestational age and birth weight but a significantly higher median CRP compared to infants in the no sepsis group (37.5 mg/L vs. 18.1 mg/L, P = 0.0016). When infants were evaluated based on CRP level, we found that 67% of the infants with CRP <8 mg/L had their antibiotics discontinued compared to 43% of the infants with CRP ≥8 mg/L (P = 0.002). Conclusion: A single CRP level done at the time of a neonatal sepsis evaluation can assist in decision-making regarding the continuance of antibiotic therapy. The use of CRP among infants undergoing sepsis evaluation in the NICU significantly affected the decision of medical providers to discontinue antimicrobial agents. This is consistent with the American Academy of Pediatrics Committee on Fetus and Newborn recommendation that bacterial sepsis is unlikely with normal CRPs and antibacterial agents may be discontinued.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded694    
    Comments [Add]    
    Cited by others 3    

Recommend this journal