Backround and aims Clinical diagnosis of neonatal sepsis has always been challenging. Recent studies have suggested that Interleukin-6 assays can be useful in diagnosis of sepsis alongside CRP. This study looks at the influence of IL-6 and CRP results on clinical decision making.
Methods A prospective web-based questionnaire survey of both junior doctors (online survey) and Consultants (focus group) was carried out using 20 hypothetical scenarios of neonatal sepsis along with hypothetical IL-6 and CRP results. The differences in diagnostic certainty of sepsis on the basis of clinical history alone were compared with that of addition of CRP and IL-6 results, within and between both the trainee and expert groups. (Expert group consensus responses were considered as gold-standard).
Results Experts: Based on clinical history, CRP and IL-6 results, experts agreed to the possibility of sepsis in only 25% of the clinical situations. Antibiotic usage by experts subsequent to sepsis categorisation was reduced with the availability of CRP results. (55% after IL-6 vs. 30% after CRP results).
Trainees: CRP results were shown to be statistically significant in changing clinician’s decisions. Trainees favoured a greater likelihood of sepsis when IL-6 results were available prior to CRP results. Using the focus group consensus as gold standard, IL-6 results were used by trainees for confirming sepsis irrespective of whether they were available prior to or after CRP results.
Conclusion Both point-of-care IL-6 test results and CRP results helped doctors in confirming a diagnosis of sepsis. IL-6 was not useful in ruling out sepsis.