Table of Contents

HK J Paediatr (New Series)
Vol 10. No. 1, 2005

HK J Paediatr (New Series) 2005;10:3-9

Original Article

Reducing Hospitalisation and Antibiotic Use in Suspected Early Neonatal Sepsis through Serial Measurements of C-reactive Proteins

WK Lee, ML Chan, BWY Young


Objective: To evaluate whether a standard practice of serial measurements of C-reactive protein (CRP) would reduce the duration of hospitalisation and antibiotic use in newborn infants with birth weight 2.2 kg or more and having clinical features of suspected early neonatal sepsis. Study design: This is a retrospective observational study comparing two groups of newborns with birth weight 2.2 kg or more managed for suspected early neonatal sepsis before and after adoption of a clinical protocol of measuring two serial CRP to guide stopping antibiotics in 1999. The protocol involved checking the first CRP 8 to 16 hours after the initial evaluation and the second CRP one day after the first one. A cut-off value of less than 10 mg/L for the serial CRP was used as a guide to stop the antibiotics. The mortality, duration of hospitalisation and antibiotics of 76 infants managed in 2000 were compared to those of a group of 80 infants in 1998. Results: One infant in the study group died but the death was unrelated to sepsis. The median hospital stay was shorter in the study group (7.0 vs 8.0 days, p=0.03). The median duration of antibiotics was also shorter in the study group (3.0 vs 7.0 days, p < 0.005). Three infants (3.9%) in the study group and none in the control group required repeated sepsis evaluation and new antibiotics within one week of cessation of the initial antibiotics (no statistical significance). No infants in either group were readmitted within one week of discharge. Conclusion: After applying a protocol of measuring C-reactive protein serially in the management of suspected early neonatal sepsis, the duration of hospitalisation and antibiotic use may be reduced for infants with birth weight 2.2 kg or more.

Keyword : Acute phase reactant and protocol; C-reactive protein; Infection; Newborn

Abstract in Chinese


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