SynthesisBMJ open2018
Use of C-reactive protein to tailor antibiotic use: a systematic review and meta-analysis.
Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses 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
37 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Discontinuation of empirical antibiotics in suspected neonatal early-onset sepsis: a systematic review and meta-analysis.Pediatric research · 2026Pooled it
- Rapid tests to inform triage and antibiotic prescribing decisions for adults presenting with suspected acute respiratory infection: a rapid evidence synthesis of clinical effectiveness and cost-utility studies.Health technology assessment (Winchester, England) · 2025Pooled it
- Use of C-reactive protein to guide the antibiotic therapy in hospitalized patients: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- Trial
- Trial
- Effects of primary care C-reactive protein point-of-care testing on antibiotic prescribing by general practice staff: pragmatic randomised controlled trial, England, 2016 and 2017.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2020Trial
- Temporal shifts in area-level access to cycling infrastructure for equity-deserving groups in three Canadian cities: A descriptive epidemiologic study.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- The diagnostic performance of point-of-care tests for serum amyloid A and C-reactive protein in lame sows.Acta veterinaria Scandinavica · 2026Article
- Role of biomarkers in pediatric sepsis: What evidence says?World journal of clinical pediatrics · 2026Review
- Heparin Binding Protein in Sepsis-A Comprehensive Overview of Pathophysiology, Clinical Usage and Utility as Biomarker.Biomedicines · 2025Review
- Interplay between C-reactive protein responses and antibiotic prescribing in people with suspected infection.BMC infectious diseases · 2025Article
- Antimicrobial stewardship principles in the evaluation of empirical carbapenem antibiotics in a private hospital in South Africa.JAC-antimicrobial resistance · 2025Article
- Infective Complications of Endobronchial Ultrasound-Transbronchial Needle Aspiration (EBUS-TBNA) and Clinical Biomarkers: A Concise Review.Diagnostics (Basel, Switzerland) · 2025Review
- Within-individual variation of C-reactive protein (CRP) measurements in primary care: A retrospective cohort study.PloS one · 2025Article
- De-implementation strategy to reduce unnecessary antibiotic prescriptions for ambulatory HIV-infected patients with upper respiratory tract infections in Mozambique: a study protocol of a cluster randomized controlled trial.Implementation science : IS · 2024Article
- Article
- Distinct patterns of vital sign and inflammatory marker responses in adults with suspected bloodstream infection.The Journal of infection · 2024Article
- Biomarkers in sepsis-looking for the Holy Grail or chasing a mirage!World journal of critical care medicine · 2023Review
- Hemoglobin and Its Z Score Reference Intervals in Febrile Children: A Cohort Study of 98,572 Febrile Children.Children (Basel, Switzerland) · 2023Article
- Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients.Intensive care medicine · 2023Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesC-reactive protein (CRP) has been proposed to guide the use of antibiotics. However, study results are controversial regarding the benefits of such a strategy. We synthesised the evidence of CRP-based algorithms on antibiotic treatment initiation and on antibiotic treatment duration in adults, children and neonates, as well as their safety profile.
designSystematic review and meta-analysis. DATA SOURCES: MEDLINE, EMBASE, CENTRAL and CINAHL from inception to 20 July 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included randomised controlled trials (RCTs), non-RCTs and cohort studies (prospective or retrospective) investigating CRP-guided antibiotic use in adults, children and neonates with bacterial infection. DATA EXTRACTION AND SYNTHESIS: Two researchers independently screened all identified studies and retrieved the data. Outcomes were duration of antibiotic use, antibiotic initiation, mortality, infection relapse and hospitalisation. We assessed the quality of the included studies using the Cochrane Collaboration's tool (RCTs), and A Cochrane Risk Of Bias Assessment Tool: for Non-Randomized Studies of Interventions and the Newcastle-Ottawa scale (non-RCTs). We analysed our results using descriptive statistics and random effects models.
resultsOf 11 165 studies screened, 15 were included. In five RCTs in adult outpatients, the risk difference for antibiotic treatment initiation in the CRP group was -7% (95% CI: -10% to -4%), with no difference in hospitalisation rate. In neonates, CRP-based algorithms shortened antibiotic treatment duration by -1.45 days (95% CI -2.61 to -0.28) in two RCTs, and by -1.15 days (95% CI -2.06 to -0.24) in two cohort studies, with no differences in mortality or infection relapse.
conclusionThe use of CRP-based algorithms seems to reduce antibiotic treatment duration in neonates, as well as to decrease antibiotic treatment initiation in adult outpatients. However, further high-quality studies are still needed to assess safety, particularly in children outside the neonatal period. PROSPERO REGISTRATION NUMBER: CRD42016038622.
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