title: Serial measurement of the C-reactive protein is a poor predictor of treatment outcome in prosthetic joint infection.
abstract: OBJECTIVE
  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.
  
  
  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.affiliation: Bone Infection Unit, Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK. pbejon@well.ox.ac.uk
authors.forename: Philip
authors.initials: P
authors.lastname: Bejon
authors.forename: Ivor
authors.initials: I
authors.lastname: Byren
authors.forename: Bridget L
authors.initials: BL
authors.lastname: Atkins
authors.forename: Matthew
authors.initials: M
authors.lastname: Scarborough
authors.forename: Andrew
authors.initials: A
authors.lastname: Woodhouse
authors.forename: Peter
authors.initials: P
authors.lastname: McLardy-Smith
authors.forename: Roger
authors.initials: R
authors.lastname: Gundle
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Berendt
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis*; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy* / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000601:surgery*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein