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Year : 2020  |  Volume : 7  |  Issue : 1  |  Page : 20-24

Patterns of C-reactive protein ratio response in ventilation-associated pneumonia

Department of Critical Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

Correspondence Address:
MD Waleed S Abdelhady Mohamed
Department of Critical Medicine, Faculty of Medicine, University of Alexandria, Alexandria
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/roaic.roaic_98_18

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Introduction Physicians frequently use serum biomarkers to assist in clinical response to antibiotic therapy in patients having ventilator-associated pneumonia (VAP). C-reactive protein (CRP) is one of these biomarkers and probably the most widely used. Aim of the work This study was aimed to evaluate the course of CRP and identify the patterns of CRP ratio response to antibiotic therapy during the first week in patients with VAP who are admitted to Critical Care Medicine Department in Alexandria University Hospital. Patients and methods This study will be conducted on 60 adult patients of both sexes who admitted to Critical Care Department, Alexandria Main University Hospital of patients complicated with VAP. All cases were subjected to: history taking from the patient or next of kin including: age, gender, associated medical diseases, Acute Physiology and Chronic Health Evaluation II, and sequential organ failure assessment score. CRP was assessed on admission (D0), day1 (D1), and day 5 (D5). Results The study patients were classified into two groups: group I ‘good response’ to treatment of pneumonia and group II ‘poor response’ to treatment of pneumonia. The patients who showed good response were 36 (60.0%), whereas 24 (40.0%) patients showed poor response. Discussion In our study, survivors showed a continuous and significant decrease of CRP ratio during the first week of antibiotic therapy. Conversely, in nonsurvivors, CRP ratio remained elevated, and at D5, a CRP ratio of higher than 0.5 was associated with a fivefold increase in the risk of death in the ICU. Interestingly, in our study, patients with nonresponse CRP ratio pattern presented a significantly higher ICU mortality than patients with fast or slow response patterns. Conclusion The use of serial CRP determinations is useful in monitoring therapeutic response of serious infection, allowing early identification of complications or antibiotic failures.

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