Usefulness of C-reactive protein in monitoring the severe community-acquired pneumonia clinical course 英文参考文献.docVIP

Available online /content/11/4/R92 Research Open Access Vol 11 No 4 Usefulness of C-reactive protein in monitoring the severe community-acquired pneumonia clinical course Luís Coelho, Pedro Póvoa, Eduardo Almeida, Antero Fernandes, Rui Mealha, Pedro Moreira and Henrique Sabino Unidade de Cuidados Intensivos, Hospital Garcia de Orta, Almada, Portugal Corresponding author: Luís Coelho, luismiguelcoelho16@ Received: 5 Jun 2007 Revisions requested: 4 Jul 2007 Revisions received: 10 Aug 2007 Accepted: 28 Aug 2007 Published: 28 Aug 2007 Critical Care 2007, 11:R92 (doi:10.1186/cc6105) This article is online at: /content/11/4/R92 ? 2007 Coelho et al., licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/ 2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background The aim of the present study was to evaluate the C-reactive protein level, the body temperature and the white cell count in patients after prescription of antibiotics in order to describe the clinical resolution of severe community-acquired pneumonia. response and 74% of patients with a slow response pattern survived, whereas those patients with the patterns of nonresponse and of biphasic response had a mortality rate of 100% and 33%, respectively (P 0.001). On day 3 of antibiotic therapy, a decrease in C-reactive protein levels by 0.31 or more from the previous days level was a marker of good prognosis (sensitivity, 0.75; specificity, 0.85). Methods A cohort of 53 consecutive patients with severe community-acquired pneumonia was studied. The C-reactive protein levels, body temperature and white cell count were monitored daily. Conclusion Daily C-reactive protein measurement after antibiotic prescription is useful in identification, as early as day 3, of sev