¿Existen bases para el uso de la proteína C reactiva en la detección de infecciones bacterianas en niños?: A review

Although C-Reactive protein (CRP) was described more than 70 years ago and it still is commonly used in practice, studies exploring its usefulness persist while some propose its replacement by other inflammatory acute-phase-mediators. The aim of this clinical review is to answer the question if CRP...

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Autores principales:	Herrera L,Patricio, Duffau T,Gaston
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2005
Materias:	Anti-bacterial agents Bacterial infections C-reactive protein Child
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000500005
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spelling	oai:scielo:S0034-988720050005000052005-06-17¿Existen bases para el uso de la proteína C reactiva en la detección de infecciones bacterianas en niños?: A reviewHerrera L,PatricioDuffau T,Gaston Anti-bacterial agents Bacterial infections C-reactive protein Child Although C-Reactive protein (CRP) was described more than 70 years ago and it still is commonly used in practice, studies exploring its usefulness persist while some propose its replacement by other inflammatory acute-phase-mediators. The aim of this clinical review is to answer the question if CRP measurement warrant clinical decisions for febrile children because it discriminates between bacterial from non bacterial etiologies. We made a systematic search by means of MEDLINE, SciELO and LILACS with the following MESH terms: "C-reactive protein", "bacterial", "infection", "children", "diagnosis" or "detection", besides the Haynes selector for articles on diagnosis, between 1950 and 2004. Selection data extraction and critical appraisal were independently made by the two authors, following standard criteria. We selected 7 primary articles, 3 clinical reviews and two randomized clinical trials. There was no disagreement between reviewers. Only one of the clinical reviews followed standard guidelines; two reviews concluded that no isolated CRP values would warrant to make decisions on starting or withholding antimicrobial therapy in febrile children. All primary articles showed methodological flaws in basic validity criteria. Both randomized clinical trials showed that CRP results did not change either doctor's decisions about antimicrobial prescriptions nor the studied patients' prognosis. We did not find evidences that could warrant the use of CRP for the defined problem in Pediatrics. Main problems affecting validity of studies on CRP as diagnostic resource are the lack of laboratory methods uniformity -including the gold standard make up- the heterogeneity of cut off points, clinical spectrum inappropriateness of study groups as well as the resulting diversity of the fixed indexes values. Moreover, no validation of this test in children population has been made so farinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.5 20052005-05-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000500005es10.4067/S0034-98872005000500005
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Anti-bacterial agents Bacterial infections C-reactive protein Child
spellingShingle	Anti-bacterial agents Bacterial infections C-reactive protein Child Herrera L,Patricio Duffau T,Gaston ¿Existen bases para el uso de la proteína C reactiva en la detección de infecciones bacterianas en niños?: A review
description	Although C-Reactive protein (CRP) was described more than 70 years ago and it still is commonly used in practice, studies exploring its usefulness persist while some propose its replacement by other inflammatory acute-phase-mediators. The aim of this clinical review is to answer the question if CRP measurement warrant clinical decisions for febrile children because it discriminates between bacterial from non bacterial etiologies. We made a systematic search by means of MEDLINE, SciELO and LILACS with the following MESH terms: "C-reactive protein", "bacterial", "infection", "children", "diagnosis" or "detection", besides the Haynes selector for articles on diagnosis, between 1950 and 2004. Selection data extraction and critical appraisal were independently made by the two authors, following standard criteria. We selected 7 primary articles, 3 clinical reviews and two randomized clinical trials. There was no disagreement between reviewers. Only one of the clinical reviews followed standard guidelines; two reviews concluded that no isolated CRP values would warrant to make decisions on starting or withholding antimicrobial therapy in febrile children. All primary articles showed methodological flaws in basic validity criteria. Both randomized clinical trials showed that CRP results did not change either doctor's decisions about antimicrobial prescriptions nor the studied patients' prognosis. We did not find evidences that could warrant the use of CRP for the defined problem in Pediatrics. Main problems affecting validity of studies on CRP as diagnostic resource are the lack of laboratory methods uniformity -including the gold standard make up- the heterogeneity of cut off points, clinical spectrum inappropriateness of study groups as well as the resulting diversity of the fixed indexes values. Moreover, no validation of this test in children population has been made so far
author	Herrera L,Patricio Duffau T,Gaston
author_facet	Herrera L,Patricio Duffau T,Gaston
author_sort	Herrera L,Patricio
title	¿Existen bases para el uso de la proteína C reactiva en la detección de infecciones bacterianas en niños?: A review
title_short	¿Existen bases para el uso de la proteína C reactiva en la detección de infecciones bacterianas en niños?: A review
title_full	¿Existen bases para el uso de la proteína C reactiva en la detección de infecciones bacterianas en niños?: A review
title_fullStr	¿Existen bases para el uso de la proteína C reactiva en la detección de infecciones bacterianas en niños?: A review
title_full_unstemmed	¿Existen bases para el uso de la proteína C reactiva en la detección de infecciones bacterianas en niños?: A review
title_sort	¿existen bases para el uso de la proteína c reactiva en la detección de infecciones bacterianas en niños?: a review
publisher	Sociedad Médica de Santiago
publishDate	2005
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000500005
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¿Existen bases para el uso de la proteína C reactiva en la detección de infecciones bacterianas en niños?: A review

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