CRP-guided protocol reduces treatment time in acute bacterial infections

A new study published in BMC Infectious Diseases suggests that when compared to conventional protocols of treatment, the adoption of CRP-guided protocols shortens the overall time needed for antibiotic therapy in hospitalized patients with acute bacterial infections.

An inflammatory protein called C-reactive protein (CRP) is utilized in clinical practice to recognise and keep track of inflammatory and infectious diseases. Recent research indicates that CRP may help critical care patients decide whether to stop taking their antibiotics. In order to compare the advantages and disadvantages of CRP-guided regimens for antibiotic therapy in hospitalized patients to routine care, Raphael Figuiredo Dias and colleagues performed this meta-analysis.

Four databases—CENTRAL, Embase, Medline, and LILACS—were searched for studies. Up to January 25th, 2023, the search was conducted. To locate potentially overlooked qualifying trials, the reference lists of the publications collected and associated review studies were manually searched. The length of antibiotic therapy for the index episode of illness was one of the primary objectives. The all-cause hospital mortality and infection relapses were the secondary endpoints. The Cochrane Risk of Bias 2.0 tool was used to assess the risk of bias. The mean differences and odds ratios from several research were combined using random effects. 

The key findings of this study were:

Three papers were eligible and included in this meta-analysis out of the 5209 titles that were returned by the search approach. 

The analysis involved 727 adult patients, of whom 278 were in the intervention group and 449 were in the control group. 

Women made up 55,7% of all patients. 

According to a meta-analysis, experimental groups (CRP-guided) received antibiotics for fewer days on average, with no difference in mortality or the likelihood of infection recurrence.

In hospitalized patients with acute bacterial infections, the length of antibiotic therapy (days) was safely decreased in half by the CRP-guided method. Regarding mortality and infection recurrence rates, researchers found no statistically significant differences.

Reference: 

Dias, R. F., de Paula, A. C. R. B., Hasparyk, U. G., de Oliveira Rabelo Bassalo Coutinho, M., Silva, R. A. M., Guimarães, N. S., Simões e Silva, A. C., & Nobre, V. (2023). Use of C-reactive protein to guide the antibiotic therapy in hospitalized patients: a systematic review and meta-analysis. In BMC Infectious Diseases (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12879-023-08255-3