Introduction C-reactive protein (CRP) is plasma protein from the acute phase of inflammation produced from the liver. Normal references in blood CRP of <5–10 mg/l level depend on the infection (in bacterial infections CRP >10 mg/l, in viral infections CRP <10 mg/l).
Objective Distinguishing bacterial and viral infections in primary care and monitoring the efficacy of antibiotic therapy based on the value of CRP and correlation with white blood cells (WBC).
Methods Monthly reports of primary care for the Paediatric Department were used in the period 1 October to 31 December 2007, which are compared with the data used in this study, which were 339 patients aged 1 month to 18 years in the period from 1 January to 31 March 2008. Values of CRP were measured with visual agglutination and immunoturbidimetry, whereas WBC results were from sophisticated electronic instruments.
Results From 339 patients, 83 cases showed CRP >10 mg/l (24.4% bacterial infection) treated with different antibiotics, whereas in 256 cases CRP was <10 mg/l (75.52% viral infection) treated with symptomatic therapy. Those were mainly infections of the upper and lower respiratory tract, gastrointestinal and urinary tract, etc. Also, the analysis shows that a high value of CRP does not match with a high number of WBC (from 83 patients with CRP >10 mg/l only in 39 cases were WBC high), whereas in 44 patients CRP was shown to be an early indicator of bacterial infection.
Conclusions Antibiotic prescriptions in primary care are used in more than 70% of infections. CRP is one of the most sensitive indicators in the determination and adequate treatment of infections; reduce antibiotic prescriptions when it is of “little or no benefit”, lower the risk of “antibiotic-resistant bacteria…”.