procalcitonin,crp in neonate

[agoz]

can procalcitonin be used in neonates ? is it superior then crp ? what is sepis value ? when it is positive (for example premature ruptur of membranes 6  hour after birth or earlier) ?

[Dr Ashish Jain]

The PCT as an Acute phase reactant raises far early than CRP ( within 24 hrs) , but may be after 6-8 hrs . Moreover, the levels have less variability with the regard to the birth weight and gestation , with some studies also confirming its role in prognosis when done serially ( See Neopins) . Hence , this may be better than CRP for the EOS obviously.

For now , a negative PCT that persists has a strong NPV and the antibiotics may be stopped /May see the Neopin trial and the Commentary.

But remember  to look at the nomograms at different age / rather than use only one value 

[agoz]

1 hour ago, Dr Ashish Jain said:

The PCT as an Acute phase reactant raises far early than CRP ( within 24 hrs) , but may be after 6-8 hrs . Moreover, the levels have less variability with the regard to the birth weight and gestation , with some studies also confirming its role in prognosis when done serially ( See Neopins) . Hence , this may be better than CRP for the EOS obviously.

For now , a negative PCT that persists has a strong NPV and the antibiotics may be stopped /May see the Neopin trial and the Commentary.

But remember  to look at the nomograms at different age / rather than use only one value 

Thanks 

I haven't understood abbrevation "EOS".

NPV: negative predictive value?

[Dr Ashish Jain]

EOS : Early onset Sepsis

[agoz]

eos: early onset sepsis  as I found.

[HickOnACrick]

We are moving away from obtaining CRPs, CBCs, and/or procalcitonin levels in our NICU and nursery. The EOS calculator is far better as a predictor of early onset sepsis in infants >34 weeks. It is free on line, and there is a free app for iOS software. 

In babies <34 weeks, we still obtain CRPs and CBCs, but we weigh maternal factors more than lab values.