Validity Of C-Reactive Protein In Deciding The Duration Of Antibiotic Therapy In Suspected Neonatal Sepsis

Abstract

Introduction: Neonatal sepsis is the term used to describe any invasive bacterial infection that develops within the first month of life. It is considered to have an early onset if it presents within the first week and late onset if beyond the first week. According to previous studies, the prevalence rate of NS is between 10 and 15 per 1000 live births in the industrialised world and between 15 and 25 per 1000 live births in South Asia. In underdeveloped nations, 30 to 40% of all new-born deaths are caused by neonatal sepsis.

Aim: To evaluate the adequacy of serum C Reactive Protein in diagnosis of Neonatal Sepsis and role of CRP in determining the duration of antibiotic treatment in Neonatal Sepsis.

Methods: 135 babies who were suspected to have neonatal sepsis within the duration of 1 year from September 2021 to September 2022 were a part included in the study.

Results: Out of 135 babies, 77 (57.1%) were male and 58 (42.9%) were female, male preponderance noted. Most of the babies, 86 (63.8%) presented in first week of life, 40 (29.6%) in second week of life and remaining, 9 (6.6%) presented in within one month of life. Out of these 135 babies, 102 (75.5%) were confirmed to have sepsis using blood culture reports and standard sepsis screening. CRP results were Positive in  85  (62.9%)  neonates  on first  baseline measurement and were positive in 103 (76.29%) neonates after 72 hours of admission. The sensitivity of CRP in diagnosing sepsis was 98.03%, specificity was 91.0%, positive predictive value (PPV) was 97% and negative predictive value (NPV) was 93.7%.

Conclusion: Serum CRP level is a reliable indicator in establishing diagnosis and accurately monitoring the    duration of antibiotic therapy and results in significant reduction in treatment duration of   Neonatal Sepsis.