C-reactive protein: a useful marker for guiding duration of antibiotic therapy in suspected neonatal septicaemia?

The study aimed to determine whether serum C-reactive protein (CRP) levels can be used to identify when antibiotics can safely be discontinued in cases of suspected neonatal septicaemia. Neonates with suspected neonatal septicaemia treated at a hospital in Al Ramadi city, Iraq, in 2005 had serum CRP and blood cultures (the gold standard) done at admission and at 48 hours, 4 days and 6 days after starting treatment. Of the 55 neonates, CRP was ≤ 6 mg/L at 48 hours in 37 (67.3%) and antibiotics could be stopped in 32 (82.5%), i.e. when blood culture was negative. The moderate sensitivity (78%) and negative predictive value (86%) of serum CRP in this study suggest that this test alone cannot be used for guiding duration of antibiotic treatment for neonatal sepsis.