Reduction of unnecessary antibiotic therapy in newborn infants using interleukin-8 and C-reactive protein as markers of bacterial infections.
To examine whether the determination of interleukin 8 (IL-8) and C-reactive protein (CRP) in neonates with suspected nosocomial bacterial infection (NBI) is feasible and cost-effective in reducing antibiotic therapy.
Between April 1996 and May 1997, IL-8 was measured 260 times along with blood cultures, CRP, and immature-to-total-neutrophil (IT) ratio for suspected NBI in term and preterm neonates.
All infants were retrospectively analyzed for NBI.
Sensitivity, specificity, positive and negative predictive values, and 95% confidence intervals were calculated for IL-8, CRP, and IT ratio.
Receiver-operating characteristic curves were analyzed to determine optimal thresholds.
Between June 1997 and June 1998, IL-8 was measured 215 times in newborn infants with suspected NBI and the decision to start antibiotic therapy was based on increased IL-8 and/or CRP values.
A cost-effectiveness analysis was performed and sensitivity, specificity, and receiver-operating characteristic curves were reevaluated.
At the first suspicion of NBI, the combination of IL-8 >= 53 pg/mL and/or CRP>10 mg/L detected culture-proven NBI with 96% sensitivity.
The combined culture-proven and clinical NBI were detected with 93% sensitivity and 80% specificity. (...)
Mots-clés Pascal : Bactériose, Infection, Interleukine 8, Protéine C réactive, Cytokine, Infection nosocomiale, Analyse coût efficacité, Réduction, Antibiotique, Chimiothérapie, Traitement, Economie santé, Marqueur biologique, Evaluation performance, Diagnostic, Nouveau né, Homme
Mots-clés Pascal anglais : Bacteriosis, Infection, Interleukin 8, C reactive protein, Cytokine, Nosocomial infection, Cost efficiency analysis, Reduction, Antibiotic, Chemotherapy, Treatment, Health economy, Biological marker, Performance evaluation, Diagnosis, Newborn, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0494723
Code Inist : 002B05B02O. Création : 22/03/2000.