CRP is a useful marker to predict antibiotic response and outcome in infections following major abdominal surgery

Recently published study by Perrella et al. evaluated the usefulness of C-reactive protein (CRP) and procalcitonin (PCT) as markers of infection, sepsis and as predictors of antibiotic response after non-emergency major abdominal surgery. Surgical procedure may be a predisposing factor to infectious complications and consequently sepsis, influencing the patient prognosis, hospital length of stay and therefore being an issue also in antimicrobial resistance onset. Therefore, markers to determine an earlier onset of infection and possible response to antibiotic treatment are fundamental.

The study was performed as observational study from January 2015 to June 2019. They enrolled a total of 260 patients who underwent non-emergency major abdominal surgery: 140 out of 260 were classified as non-infection group (Group A) while 120 were found to be affected by infections at the time of surgery or after surgical procedure with one or more microbes (Group B). Serum CRP (cut-off value < 5 mg/L) and PCT (cut-off value < 0.1mcg/L) were measured day before surgical procedure (T0), 48 h after surgery (T1) and every 48 h as well as at the time of fever onset (T2,T3..Tn).

The study results showed that PCT serum levels did not show any statistically significant difference among patients with or without infection after major abdominal surgery in all observed time points. PCT had a trend to early increase after surgical procedure in all patients but did not show any variation according to treatment response. However, CRP was increased after surgery in those patients presenting infection. CRP also showed a statistically significant trend to decrease in those being responsive to antibiotic treatment. The study concluded that although CRP has been considered a non-specific inflammation marker, it seems to be a useful laboratory tool to predict early onset of the infection as well as antibiotic treatment response.

Read the original article: https://link.springer.com/article/10.1007/s13304-021-01172-7