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Is routine measurement of the serum C‐reactive protein level helpful during antibiotic therapy for diabetic foot infection?
Author(s) -
Pham TruongThanh,
Wetzel Oliver,
Gariani Karim,
Kressmann Benjamin,
Jornayvaz François R.,
Lipsky Benjamin A.,
Uçkay İlker
Publication year - 2021
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.14222
Subject(s) - medicine , c reactive protein , diabetic foot , antibiotic therapy , antibiotics , prospective cohort study , diabetes mellitus , clinical trial , surgery , gastroenterology , inflammation , endocrinology , biology , microbiology and biotechnology
Clinicians frequently monitor serum C‐reactive protein (CRP) levels during therapy for diabetic foot infections (DFIs), but evidence supporting this is unclear. Using a database from prospective controlled DFI trials, with fixed duration of antibiotic therapy, we correlated the CRP levels at study enrolment and at end of therapy (EOT). Among 159 DFI episodes, 93 involved the bone and 66 the soft tissues. Overall, treatment cured 122 infections (77%), while 37 episodes (23%) recurred after a median of 53 days. The median CRP in the groups with cure versus failure differed minimally at enrolment (median 67 vs. 81 mg/L) or EOT (7 vs. 10 mg/L). Similarly, there was negligible difference in the percentage of CRP levels that normalized at EOT (39% vs. 35%). In our prospective cohorts, a blunt iterative monitoring of CRP during DFI treatment, without correlation with clinical findings, failed to predict treatment failures.