NIHR Signal -C-reactive protein is not useful in diagnosing late-onset infection in newborns

Published on 20 March 2019

The blood level of C-reactive protein (CRP), a marker indicating inflammation in the body, is not accurate enough alone to diagnose late-onset infection in newborn infants.

Late-onset neonatal infection, occurring more than three days after birth, is potentially serious and is relatively common. Tests measuring the blood level of CRP are widely used by physicians to guide their decision on whether or not to start antibiotic treatment for suspected infection.

This NIHR-funded review found 20 studies, including 1,615 hospitalised infants, comparing the use of CRP to bacterial culture of the blood in children with suspected infection. For every 1,000 babies, assuming 40% have an infection, 152 cases of infection would be missed, and 156 would receive unnecessary antibiotics if the decision was just based on CRP.

The findings cast doubt on the use of CRP for this purpose.

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