Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
Orthopedic Surgery Service, Geneva University Hospitals, Geneva, Switzerland.
Diabetes Obes Metab. 2021 Feb;23(2):637-641. doi: 10.1111/dom.14222. Epub 2020 Oct 26.
Clinicians frequently monitor serum C-reactive protein (CRP) levels during therapy for diabetic foot infections (DFIs), but evidence supporting this is unclear. Using a database from prospective controlled DFI trials, with fixed duration of antibiotic therapy, we correlated the CRP levels at study enrolment and at end of therapy (EOT). Among 159 DFI episodes, 93 involved the bone and 66 the soft tissues. Overall, treatment cured 122 infections (77%), while 37 episodes (23%) recurred after a median of 53 days. The median CRP in the groups with cure versus failure differed minimally at enrolment (median 67 vs. 81 mg/L) or EOT (7 vs. 10 mg/L). Similarly, there was negligible difference in the percentage of CRP levels that normalized at EOT (39% vs. 35%). In our prospective cohorts, a blunt iterative monitoring of CRP during DFI treatment, without correlation with clinical findings, failed to predict treatment failures.
临床医生在治疗糖尿病足感染 (DFI) 期间经常监测血清 C 反应蛋白 (CRP) 水平，但支持这一点的证据并不明确。我们使用前瞻性对照 DFI 试验的数据库，其中抗生素治疗的持续时间固定，将研究入组时和治疗结束时 (EOT) 的 CRP 水平进行了相关性分析。在 159 例 DFI 发作中，93 例涉及骨骼，66 例涉及软组织。总体而言，治疗治愈了 122 例感染（77%），而 37 例感染（23%）在中位时间为 53 天后复发。在入组时（中位数 67 与 81mg/L）或 EOT 时（7 与 10mg/L），治愈组和失败组的 CRP 中位数差异极小。同样，EOT 时 CRP 水平正常化的百分比差异也可以忽略不计（39%与 35%）。在我们的前瞻性队列中，DFI 治疗期间对 CRP 的盲目迭代监测，与临床发现没有相关性，未能预测治疗失败。
