Equivalence study between plasmatic C reactive protein level and antibiotic use in a pediatrics unit

Abstract

Background: C-reactive protein (CRP) is a commonly used inflammatory acute-phase mediator that constitutes a useful tool for differentiating bacterial from viral infections, although its role is not clearly supported by scientific evidence. We review the results of CRP exams done in our hospital, checking the concordance between CRP level obtained and use of antibiotics, in order to evaluate if the physician considers these results when deciding the use of antibiotics.

Method: Evaluation of 165 exams in laboratory records of our hospital, in order to select those belonging to patients with a febrile syndrome without receiving antibiotics, in which CRP was taken in the first laboratory evaluation. Analysis of concordance between high levels of CRP (> 60) and use of antibiotics.

Results: We observed low concordance (kappa index of 0.479), showing that physicians frequently do not consider CRP results when deciding the use of antibiotics.

Conclusions: Low concordance between levels of CRP and use of antibiotics must be considered at the moment of evaluating the cost-benefit ratio of this specific test.