Is routine measurement of the serum C-reactive protein level helpful during antibiotic therapy for diabetic foot infection?

Autor: Pham TT; Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.; Orthopedic Surgery Service, Geneva University Hospitals, Geneva, Switzerland., Wetzel O; Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland., Gariani K; Service of Endocrinology, Diabetes, Nutrition and Patient Therapeutic Education, Geneva University Hospitals, Geneva, Switzerland., Kressmann B; Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.; Orthopedic Surgery Service, Geneva University Hospitals, Geneva, Switzerland., Jornayvaz FR; Service of Endocrinology, Diabetes, Nutrition and Patient Therapeutic Education, Geneva University Hospitals, Geneva, Switzerland., Lipsky BA; Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.; Department of Medicine, University of Washington, Seattle, WA, USA., Uçkay İ; Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.; Orthopedic Surgery Service, Geneva University Hospitals, Geneva, Switzerland.; Infectiology, Balgrist University Hospital, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: Diabetes, obesity & metabolism [Diabetes Obes Metab] 2021 Feb; Vol. 23 (2), pp. 637-641. Date of Electronic Publication: 2020 Oct 26.
DOI: 10.1111/dom.14222
Abstrakt: Clinicians frequently monitor serum C-reactive protein (CRP) levels during therapy for diabetic foot infections (DFIs), but evidence supporting this is unclear. Using a database from prospective controlled DFI trials, with fixed duration of antibiotic therapy, we correlated the CRP levels at study enrolment and at end of therapy (EOT). Among 159 DFI episodes, 93 involved the bone and 66 the soft tissues. Overall, treatment cured 122 infections (77%), while 37 episodes (23%) recurred after a median of 53 days. The median CRP in the groups with cure versus failure differed minimally at enrolment (median 67 vs. 81 mg/L) or EOT (7 vs. 10 mg/L). Similarly, there was negligible difference in the percentage of CRP levels that normalized at EOT (39% vs. 35%). In our prospective cohorts, a blunt iterative monitoring of CRP during DFI treatment, without correlation with clinical findings, failed to predict treatment failures.
(© 2020 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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