title: The time course of body temperature, serum amyloid A protein, C-reactive protein and interleukin-6 in patients with bacterial infection during the initial 3 days of antibiotic therapy.
abstract: The accuracy of using body temperature, serum amyloid A (SAA), C-reactive protein (CRP) and interleukin-6 (IL-6) in the work-up for early or late step-down therapy after an initial course of intravenous cefuroxime was investigated. Eighty-one hospitalized patients with an initial course of cefuroxime were retrospectively classified with one of the following diagnoses: bacterial infection without known focus, pneumonia, bronchitis, pyelonephritis, skin and soft-tissue infections or fever of other origin. The majority of the patients had sepsis (91% or 74/81) of whom 6 patients had severe sepsis. The inter-individual variability of body temperature, SAA, CRP and IL-6 was considerable. The time course of SAA and CRP during the first 24 h in patients with sepsis with a short duration of illness but without septic shock showed increasing levels during the initial course of intravenous therapy. In contrast, body temperature and IL-6 decreased, regardless of illness duration. Beyond 24 h, all 4 biomarkers declined, again regardless of the duration of illness. After the initial course of cefuroxime, biomarkers were non-distinguishing in terms of guidance in the judgement of early or late step-down therapy. Further studies are proposed for biomarker guidance antibiotic therapy in sepsis patients without septic shock.
authors.affiliation: Department of Medical Sciences, Section of Infectious Diseases, University Hospital, Uppsala, Sweden. anders.lannergard@akademiska.se
authors.forename: Anders
authors.initials: A
authors.lastname: Lannergård
authors.forename: Anders
authors.initials: A
authors.lastname: Viberg
authors.forename: Otto
authors.initials: O
authors.lastname: Cars
authors.forename: Mats O
authors.initials: MO
authors.lastname: Karlsson
authors.forename: Marie
authors.initials: M
authors.lastname: Sandström
authors.forename: Anders
authors.initials: A
authors.lastname: Larsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001831:Body Temperature / Q000502:physiology*; D002097:C-Reactive Protein / Q000378:metabolism*; D002444:Cefuroxime / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005334:Fever / Q000097:blood / Q000382:microbiology; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D016014:Linear Models; D008875:Middle Aged; D012189:Retrospective Studies; D000685:Serum Amyloid A Protein / Q000378:metabolism*; D018709:Statistics, Nonparametric; D013997:Time Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D015850:Interleukin-6; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein; D002444:Cefuroxime