Impact of C-reactive protein results on prolonged early antibiotic use in infants with negative cultures

Abstract

Background: Neonatal studies reporting the diagnostic performance of C-reactive protein (CRP) often use “clinical sepsis” as the outcome of interest, despite the subjective nature of this diagnosis. Blood or CSF culture is the diagnostic standard for neonatal early-onset sepsis (EOS). As the incidence of culture-confirmed EOS has declined, the statistical performance of CRP in predicting EOS and the clinical impact of its use in EOS management is questioned. While some studies report use of serial CRP to allow timely discontinuation of antibiotics, others report increases in antibiotic initiation and duration when determining antibiotic therapy on CRP results. Objective: To determine the performance of CRP in the …