Trial reportPloS one2013
Use of a computerized C-reactive protein (CRP) based sepsis evaluation in very low birth weight (VLBW) infants: a five-year experience.
Trial report in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Use of C-reactive protein to tailor antibiotic use: a systematic review and meta-analysis.BMJ open · 2018Pooled it
- Use and utility of C-reactive protein (CRP) in neonatal early-onset sepsis: a secondary analysis of a prospective surveillance study.Journal of perinatology : official journal of the California Perinatal Association · 2025Observational
- Predictive factors for perinatal bacterial transmission from colonized mothers to delivered very-low-birth-weight infants: a retrospective cohort study.Scientific reports · 2024Article
- Artificial and human intelligence for early identification of neonatal sepsis.Pediatric research · 2023Review
- Current Status of Antibiotic Stewardship and the Role of Biomarkers in Antibiotic Stewardship Programs.Infection & chemotherapy · 2022Review
- Association Between Procalcitonin and Antibiotics in Children With Community-Acquired Pneumonia.Hospital pediatrics · 2022Article
- Vital signs as physiomarkers of neonatal sepsis.Pediatric research · 2022Review
- [Sepsis risk calculator-guided antibiotic management in neonates with suspected early-onset sepsis].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2021Article
- [Risk factors for neutropenia of late newborns].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2021Article
- [C-reactive protein-guided antibiotic treatment strategy for neonates with suspected early-onset sepsis].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2020Article
- Implementation and impact of pediatric antimicrobial stewardship programs: a systematic scoping review.Antimicrobial resistance and infection control · 2020Article
- Challenges and opportunities for antibiotic stewardship among preterm infants.Archives of disease in childhood. Fetal and neonatal edition · 2019Review
- C-reactive protein for late-onset sepsis diagnosis in very low birth weight infants.BMC pediatrics · 2018Article
- Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants.BMC pediatrics · 2017Observational
- Predicting Severe Pneumonia Outcomes in Children.Pediatrics · 2016Article
- Heart rate characteristic index monitoring for bloodstream infection in an NICU: a 3-year experience.Archives of disease in childhood. Fetal and neonatal edition · 2016Article
- Intestinal microbiota and its relationship with necrotizing enterocolitis.Pediatric research · 2015Review
- Validation of serum C-reactive protein for the diagnosis and monitoring of antibiotic therapy in neonatal sepsis.Pakistan journal of medical sciencesArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSerial C-reactive protein (CRP) values may be useful for decision-making regarding duration of antibiotics in neonates. However, established standard of practice for its use in preterm very low birth weight (<1500 g, VLBW) infants are lacking.
objectiveEvaluate compliance with a CRP-guided computerized decision support (CDS) algorithm and compare characteristics and outcomes of compliant versus non-compliant cases. Measure correlation between CRPs and white blood count (WBC) indices.
methodsWe examined 3 populations: 1) all preterm VLBW infants born at Vanderbilt 2006-2011 - we assessed provider compliance with CDS algorithm and measured relevant outcomes; 2) all patients with positive blood culture results admitted to the Vanderbilt NICU 2006-2012 - we tested the correlation between CRP and WBC results within 7 days of blood culture phlebotomy; 3) 1,000 randomly selected patients out of the 7,062 patients admitted to the NICU 2006-2012 - we correlated time-associated CRP values and absolute neutrophil counts.
resultsOf 636 VLBW infants in cohort 1), 569 (89%) received empiric antibiotics for suspected early-onset sepsis. In 409 infants (72%) the CDS algorithm was followed; antibiotics were discontinued ≤48 hours in 311 (55%) with normal serial CRPs and continued in 98 (17%) with positive CRPs, resulting in significant reduction in antibiotic exposure (p<0.001) without increase in complications or subsequent infections. One hundred sixty (28%) were considered non-compliant because antibiotics were continued beyond 48 hours despite negative serial CRPs and blood cultures. Serial CRPs remained negative in 38 (12%) of 308 blood culture-positive infants from cohort 2, but only 4 patients had clinically probable sepsis with single organisms and no immunodeficiency besides extreme prematurity. Leukopenia of any cell type was not linked with CRPs in cohorts 2 and 3.
conclusionsCDS/CRP-guided antibiotic use is safe and effective in culture-negative VLBW infants. CRP results are not affected by low WBC indices.
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