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Published on: May 19, 2020
How to use: C-reactive protein
1Alder Hey Children's NHS Foundation Trust, Liverpool L12 2AP, UK.
Insights
C-reactive protein (CRP) indicates inflammation and infection. While not definitive alone, elevated CRP levels in children warrant further assessment, and persistently high levels after antibiotics suggest treatment failure.
Area of Science:
- Biochemistry
- Immunology
- Pediatrics
Background:
- C-reactive protein (CRP) is an acute-phase protein.
- It increases rapidly following inflammatory triggers and infection.
- CRP is a common marker for inflammation and bacterial infections.
Purpose of the Study:
- To evaluate the diagnostic and prognostic utility of CRP levels in identifying serious bacterial infections and guiding treatment.
- To assess the role of CRP in diagnosing neonatal sepsis.
Main Methods:
- Review of existing literature on CRP levels in pediatric infections.
- Analysis of CRP kinetics in response to inflammation and antibiotic therapy.
- Evaluation of CRP thresholds for diagnosing neonatal sepsis.
Main Results:
- A single CRP level is insufficient for diagnosing serious bacterial infections but suggests the need for further evaluation.
- Persistently elevated or rising CRP levels after 48 hours of antibiotics indicate potential treatment failure.
- Two CRP measurements below 10 mg/l, taken 24 hours apart, can help exclude neonatal sepsis.
Conclusions:
- CRP is a valuable, though not standalone, indicator in assessing pediatric infections.
- Monitoring CRP trends is crucial for evaluating treatment response and identifying therapeutic failures.
- Specific CRP criteria aid in the exclusion of neonatal sepsis.
Abstract:
C-reactive protein (CRP) is an acute-phase protein that increases 4-6 h after an inflammatory trigger and peaks at 36-50 h. Levels decrease rapidly with the resolution of inflammation. CRP is generally highly elevated in invasive bacterial infections and is often used as a marker of inflammation. A single CRP level is neither sensitive nor specific enough to identify all children with serious bacterial infection. However, a raised CRP does suggest serious bacterial infection and should suggest further assessment is needed. CRP levels that fail to decrease, or continue to rise, after 48 h of antibiotic therapy suggest treatment failure. In infants with suspected neonatal sepsis, two CRP measurements 24 h apart that are <10 mg/l are useful in excluding sepsis.
