Serial measurement of the C-reactive protein is a poor predictor of treatment outcome in prosthetic joint infection.

Journal article

OBJECTIVES: Prosthetic joint infection is usually treated using surgery and antibiotics. The response to the treatment regimen is often evaluated using serial monitoring of plasma C-reactive protein (CRP) concentrations. In order to examine how useful this monitoring is, we calculated the sensitivity and specificity of CRP concentrations for predicting treatment failure. PATIENTS AND METHODS: We examined 3732 CRP measurements from 260 patients who were treated by either two-stage revision or debridement and retention. We tested the association between CRP concentration and outcome using logistic regression models, and assessed sensitivity and specificity by using receiver operator curves. RESULTS: The areas under receiver operator curves for CRP concentrations predicting outcome ranged from 0.55 to 0.65. CONCLUSIONS: CRP concentrations did not accurately predict treatment failure. Serial monitoring may not be of benefit.

Authors: Bejon, P; Byren, I; Atkins, B; Scarborough, M; Woodhouse, A

• Publication status: Published
• Journal: Journal of antimicrobial chemotherapy
• Volume: 66
• Issue: 7
• Pages: 1590-1593
• Publication date: 2011-07-01
• DOI: 10.1093/jac/dkr182
• EISSN: 1460-2091
• ISSN: 0305-7453
• Language: English
• Keywords: Drug Monitoring; Treatment Outcome; Humans; C-Reactive Protein; Prosthesis-Related Infections; Osteoarthritis; Sensitivity and Specificity