Acute Phase Reactants in Infections: Evidence-Based Review and a Guide for Clinicians
TL;DR: There is increasing evidence to support the role of various acute phase reactants as an adjunct to clinical judgement in the management of various infections.
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Abstract: Acute-phase reactants such as erythrocyte sedimentation rate and C-reactive protein have traditionally been used as markers for inflammation and as a measure of "sickness index" in infectious and noninfectious conditions. In the last decade, more data have become available on the wider and more specific role for these markers in the management of complex infections. This includes the potential role in early diagnosis, in differentiating infectious from noninfectious causes, as a prognostic marker, and in antibiotic guidance strategies. A better defined role for biological markers as a supplement to clinical assessment may lead to more judicious antibiotic prescriptions, and it has the potential for a long-term favorable impact on antimicrobial stewardship and antibiotic resistance. Procalcitonin as a biological marker has been of particular interest in this regard. This review examines the current published evidence and summarizes the role of various acute-phase markers in infections. A MEDLINE search of English-language articles on acute-phase reactants and infections published between 1986 and March 2015 was conducted. Additional articles were also identified through a search of references from the retrieved articles, published guidelines, systematic reviews, and meta-analyses.
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Serum Procalcitonin and C-Reactive Protein Levels as Markers of Bacterial Infection: A Systematic Review and Meta-analysis
TL;DR: The diagnostic accuracy of PCT markers was higher than that of CRP markers among patients hospitalized for suspected bacterial infections and had a higher positive likelihood ratio and lower negative likelihood ratio than didCRP markers in both groups.
2012 Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infections
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Serological reactions in pneumonia with a non-protein somatic fraction of pneumococcus
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