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CRP may help guide bone and joint infection treatment
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C-reactive protein may assist clinicians in deciding when it is appropriate to switch from intravenous to oral therapy for children with bone and joint infections, according to study results published online.
John C. Arnold, MD, of the departments of pediatrics and clinical investigations at the Naval Medical Center of San Diego, and colleagues looked at 8 years of data on 194 pediatric patients with osteoarticular infections and followed the course of the C-reactive protein (CRP) with uncomplicated and complicated outcomes.
The researchers said, “CRP was highest initially among patients with acute bacterial osteomyelitis and acute bacterial arthritis and among those with complicated outcomes, and was lower at the transition to oral therapy in the complicated outcome group.”
They said their findings should be tested in a randomized trial. However, the results hold some treatment implications, particularly as it applies to those children with methicillin-resistant Staphylococcus aureus. Longer treatment courses may be required for this population of patients and for those children with more severe infections.
“The results of this sizable 8-year case series may have you in joint agreement with the authors that the CRP over time can be quite helpful therapeutically,” Pediatrics Editor Lewis First, MD, wrote in an accompanying blog.
Disclosure: Arnold reports no relevant financial disclosures.
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