Related Experiment Video
Updated: Feb 18, 2026
Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
Published on: April 19, 2024
Patterns of C-reactive protein ratio response to antibiotics in pediatric sepsis: A prospective cohort study
Vanessa Soares Lanziotti1, Pedro Póvoa2, Arnaldo Prata-Barbosa3
1D'Or Institute for Research and Education, Rio de Janeiro, RJ, Brazil; Postgraduate Program in Internal Medicine, Federal University of Rio de Janeiro (Universidade Federal do Rio de Janeiro - UFRJ), Rio de Janeiro, RJ, Brazil; Institute of Pediatrics and Child Care Martagão Gesteira, Pediatric Intensive Care Unit, Federal University of Rio de Janeiro (Universidade Federal do Rio de Janeiro- UFRJ), Rio de Janeiro, RJ, Brazil.
Insights
Sequential C-reactive protein (CRP) measurements in pediatric sepsis can predict patient outcomes. Analyzing CRP-ratio patterns in the first 7 days of antibiotic therapy helps identify children at high risk for poor prognosis in the Pediatric Intensive Care Unit (PICU).
Area of Science:
- Pediatric Critical Care Medicine
- Infectious Diseases
- Biomarker Research
Background:
- Sepsis is a life-threatening condition in children, necessitating effective monitoring tools.
- Early identification of treatment response is crucial for improving outcomes in pediatric sepsis.
- C-reactive protein (CRP) is a key inflammatory marker, but its serial evaluation patterns require further study in pediatric sepsis.
Purpose of the Study:
- To evaluate sequential C-reactive protein (CRP) measurements.
- To analyze CRP-ratio response patterns to antibiotic therapy within the first 7 days.
- To assess the utility of CRP-ratio patterns in predicting outcomes for septic children in the Pediatric Intensive Care Unit (PICU).
Main Methods:
- A prospective cohort study involving 103 children (1 month-12 years) diagnosed with sepsis across 3 PICUs.
- CRP-ratio was calculated relative to the Day 0 CRP value.
- Children were categorized into fast, slow, non-response, or biphasic CRP-ratio patterns.
Main Results:
- Overall PICU mortality was 11.7%.
- Significant differences in CRP-ratio trends were observed among the response patterns.
- Mortality rates varied significantly by CRP-ratio pattern: fast (4.5%), slow (5.8%), non-response (29.4%), and biphasic (42.8%).
Conclusions:
- Serial CRP-ratio evaluation is valuable for early identification of poor outcomes in pediatric sepsis.
- Specific CRP-ratio response patterns correlate with distinct mortality risks.
- This method aids in risk stratification and potentially guides therapeutic adjustments in septic children.
Purpose:
Evaluate sequential C-reactive protein (CRP) measurements and patterns of CRP-ratio response to antibiotic therapy during first 7days in Pediatric Intensive Care Unit (PICU) of septic children.
Methods:
Prospective, cohort study of children (1month-12years) admitted at 3 PICUs, with diagnosis of sepsis with <72h course. CRP-ratio was calculated in relation to D0_CRP value. Children were classified according to an individual pattern of CRP-ratio response: fast - CRP_D4 of therapy was <0.4 of D0_CRP; slow - continuous but slow decrease of CRP; non - CRP remained ≥0.8 of D0_CRP; biphasic - initial CRP decrease to levels <0.8 of D0_CRP followed by secondary rise ≥0.8.
Results:
103 septic children (age-median: 2yrs; 54% male) were prospectively included (infection focus: 65% respiratory, 12.5% central nervous system). Overall PICU mortality was 11.7%. 102 children could be classified according to a predefined CRP-ratio response pattern. Time-dependent analysis of CRP-ratio and CRP course of the different patterns were significantly different. Besides, PICU mortality rate was significantly different according CRP-ratio response patterns: fast response 4.5%; slow response 5.8%; non-response 29.4%; biphasic response 42.8%.
Conclusions:
In pediatric sepsis, CRP-ratio serial evaluation was useful in early identification of patients with poor outcome.
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:26Urine Studies II: Urine Culture and Sensitivity Test