Serial measurement of the C-reactive protein is a poor predictor of treatment outcome in prosthetic joint infection

J Antimicrob Chemother. 2011 Jul;66(7):1590-3. doi: 10.1093/jac/dkr182. Epub 2011 May 11.

Abstract

Objectives: Prosthetic joint infection is usually treated using surgery and antibiotics. The response to the treatment regimen is often evaluated using serial monitoring of plasma C-reactive protein (CRP) concentrations. In order to examine how useful this monitoring is, we calculated the sensitivity and specificity of CRP concentrations for predicting treatment failure.

Patients and methods: We examined 3732 CRP measurements from 260 patients who were treated by either two-stage revision or debridement and retention. We tested the association between CRP concentration and outcome using logistic regression models, and assessed sensitivity and specificity by using receiver operator curves.

Results: The areas under receiver operator curves for CRP concentrations predicting outcome ranged from 0.55 to 0.65.

Conclusions: CRP concentrations did not accurately predict treatment failure. Serial monitoring may not be of benefit.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • C-Reactive Protein / analysis*
  • Drug Monitoring / methods*
  • Humans
  • Osteoarthritis / drug therapy*
  • Osteoarthritis / surgery*
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / surgery*
  • Sensitivity and Specificity
  • Treatment Outcome

Substances

  • C-Reactive Protein