{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T17:09:52Z","timestamp":1776964192738,"version":"3.51.4"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2007,8,28]],"date-time":"2007-08-28T00:00:00Z","timestamp":1188259200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2007,8,28]],"date-time":"2007-08-28T00:00:00Z","timestamp":1188259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Background<\/jats:title>\n                        <jats:p>The aim of the present study was to evaluate the C-reactive protein level, the body temperature and the white cell count in patients after prescription of antibiotics in order to describe the clinical resolution of severe community-acquired pneumonia.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>A cohort of 53 consecutive patients with severe community-acquired pneumonia was studied. The C-reactive protein levels, body temperature and white cell count were monitored daily.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>By day 3 a C-reactive protein level 0.5 times the initial level was a marker of poor outcome (sensitivity, 0.91; specificity, 0.59). Patients were divided according to their C-reactive protein patterns of response to antibiotics, into fast response, slow response, nonresponse, and biphasic response. About 96% of patients with a C-reactive protein pattern of fast response and 74% of patients with a slow response pattern survived, whereas those patients with the patterns of nonresponse and of biphasic response had a mortality rate of 100% and 33%, respectively (<jats:italic>P<\/jats:italic> &lt; 0.001). On day 3 of antibiotic therapy, a decrease in C-reactive protein levels by 0.31 or more from the previous day's level was a marker of good prognosis (sensitivity, 0.75; specificity, 0.85).<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusion<\/jats:title>\n                        <jats:p>Daily C-reactive protein measurement after antibiotic prescription is useful in identification, as early as day 3, of severe community-acquired pneumonia patients with poor outcome. The identification of the C-reactive protein pattern of response to antibiotic therapy was useful in the recognition of the individual clinical course, either improving or worsening, as well as the rate of improvement, in patients with severe community-acquired pneumonia.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc6105","type":"journal-article","created":{"date-parts":[[2007,8,28]],"date-time":"2007-08-28T06:13:24Z","timestamp":1188281604000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["Usefulness of C-reactive protein in monitoring the severe community-acquired pneumonia clinical course"],"prefix":"10.1186","volume":"11","author":[{"given":"Lu\u00eds","family":"Coelho","sequence":"first","affiliation":[]},{"given":"Pedro","family":"P\u00f3voa","sequence":"additional","affiliation":[]},{"given":"Eduardo","family":"Almeida","sequence":"additional","affiliation":[]},{"given":"Antero","family":"Fernandes","sequence":"additional","affiliation":[]},{"given":"Rui","family":"Mealha","sequence":"additional","affiliation":[]},{"given":"Pedro","family":"Moreira","sequence":"additional","affiliation":[]},{"given":"Henrique","family":"Sabino","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2007,8,28]]},"reference":[{"key":"5541_CR1","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1136\/thorax.57.3.267","volume":"57","author":"SV Baudouin","year":"2002","unstructured":"Baudouin SV: The pulmonary physician in critical care. 3: critical care management of community acquired pneumonia. Thorax. 2002, 57: 267-271. 10.1136\/thorax.57.3.267.","journal-title":"Thorax"},{"key":"5541_CR2","doi-asserted-by":"publisher","first-page":"IV1","DOI":"10.1136\/thorax.56.4.250","volume":"56","author":"British Thoracic Society Standards of Care Committee","year":"2001","unstructured":"British Thoracic Society Standards of Care Committee: BTS Guidelines for the Management of Community Acquired Pneumonia in Adults. Thorax. 2001, 56: IV1-IV64.","journal-title":"Thorax"},{"key":"5541_CR3","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1164\/ajrccm.163.7.at1010","volume":"163","author":"MS Niederman","year":"2001","unstructured":"Niederman MS, Mandell LA, Anzueto A, Bass JB, Broughton WA, Campbell GD, Dean N, File T, Fine MJ, Gross PA, et al: Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med. 2001, 163: 1730-1754.","journal-title":"Am J Respir Crit Care Med"},{"key":"5541_CR4","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1164\/ajrccm.165.6.2103038","volume":"165","author":"V Kaplan","year":"2002","unstructured":"Kaplan V, Angus DC, Griffin MF, Clermont G, Scott Watson R, Linde-Zwirble WT: Hospitalized community-acquired pneumonia in the elderly: age- and sex-related patterns of care and outcome in the United States. Am J Respir Crit Care Med. 2002, 165: 766-772.","journal-title":"Am J Respir Crit Care Med"},{"key":"5541_CR5","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.1378\/chest.98.6.1322","volume":"98","author":"SH Feinsilver","year":"1990","unstructured":"Feinsilver SH, Fein AM, Niederman MS, Schultz DE, Faegenburg DH: Utility of fiberoptic bronchoscopy in nonresolving pneumonia. Chest. 1990, 98: 1322-1326. 10.1378\/chest.98.6.1322.","journal-title":"Chest"},{"key":"5541_CR6","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1128\/CDLI.10.5.813-820.2003","volume":"10","author":"S Fern\u00e1ndez-Serrano","year":"2003","unstructured":"Fern\u00e1ndez-Serrano S, Dorca J, Coromines M, Carratal\u00e0 J, Gudiol F, Manresa F: Molecular inflammatory responses measured in blood of patients with severe community-acquired pneumonia. Clin Diagn Lab Immunol. 2003, 10: 813-820. 10.1128\/CDLI.10.5.813-820.2003.","journal-title":"Clin Diagn Lab Immunol"},{"key":"5541_CR7","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1378\/chest.108.5.1288","volume":"108","author":"RP Smith","year":"1995","unstructured":"Smith RP, Lipworth BJ, Cree IA, Spiers EM, Winter JH: C-reactive protein. A clinical marker in community-acquired pneumonia. Chest. 1995, 108: 1288-1291. 10.1378\/chest.108.5.1288.","journal-title":"Chest"},{"key":"5541_CR8","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1172\/JCI116336","volume":"91","author":"DM Vigushin","year":"1993","unstructured":"Vigushin DM, Pepys MB, Hawkins PN: Metabolic and scintigraphic studies of radioiodinated human C-reactive protein in health and disease. J Clin Invest. 1993, 91: 1351-1357.","journal-title":"J Clin Invest"},{"key":"5541_CR9","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s00134-002-1209-6","volume":"28","author":"P Povoa","year":"2002","unstructured":"Povoa P: C-reactive protein: a valuable marker of sepsis. Intensive Care Med. 2002, 28: 235-243. 10.1007\/s00134-002-1209-6.","journal-title":"Intensive Care Med"},{"key":"5541_CR10","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/BF01709751","volume":"22","author":"JL Vincent","year":"1996","unstructured":"Vincent JL, Moreno R, Takala J, Willatts S, De Mendon\u00e7a A, Bruining H, Reinhart CK, Suter PM, Thijs LG: The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction\/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996, 22: 707-710. 10.1007\/BF01709751.","journal-title":"Intensive Care Med"},{"key":"5541_CR11","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.1097\/00003246-199811000-00016","volume":"26","author":"JL Vincent","year":"1998","unstructured":"Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S: Use of the SOFA score to assess the incidence of organ dysfunction\/failure in intensive care units: results of a multicenter, prospective study. Working group on 'sepsis-related problems' of the European Society of Intensive Care Medicine. Crit Care Med. 1998, 26: 1793-1800.","journal-title":"Crit Care Med"},{"key":"5541_CR12","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1183\/09031936.05.00071704","volume":"25","author":"P Povoa","year":"2005","unstructured":"Povoa P, Coelho L, Almeida E, Fernandes A, Mealha R, Moreira P, Sabino H: C-reactive protein as a marker of ventilator-associated pneumonia resolution: a pilot study. Eur Respir J. 2005, 25: 804-812. 10.1183\/09031936.05.00071704.","journal-title":"Eur Respir J"},{"key":"5541_CR13","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1086\/430382","volume":"40","author":"P Povoa","year":"2005","unstructured":"Povoa P, Coelho L, Almeida E, Fernandes A, Mealha R, Moreira P, Sabino H: Pilot study evaluating C-reactive protein levels in the assessment of response to treatment of severe bloodstream infection. Clin Infect Dis. 2005, 40: 1855-1857. 10.1086\/430382.","journal-title":"Clin Infect Dis"},{"key":"5541_CR14","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1148\/radiology.143.1.7063747","volume":"143","author":"JA Hanley","year":"1982","unstructured":"Hanley JA, McNeil BJ: The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982, 143: 29-36.","journal-title":"Radiology"},{"key":"5541_CR15","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1126\/science.3287615","volume":"240","author":"JA Swets","year":"1988","unstructured":"Swets JA: Measuring the accuracy of diagnostic systems. Science. 1988, 240: 1285-1293. 10.1126\/science.3287615.","journal-title":"Science"},{"key":"5541_CR16","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1148\/radiology.148.3.6878708","volume":"148","author":"JA Hanley","year":"1983","unstructured":"Hanley JA, McNeil BJ: A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology. 1983, 148: 839-843.","journal-title":"Radiology"},{"key":"5541_CR17","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1164\/ajrccm.160.2.9808045","volume":"160","author":"M Ruiz","year":"1999","unstructured":"Ruiz M, Ewig S, Marcos MA, Martinez JA, Arancibia F, Mensa J, Torres A: Etiology of community-acquired pneumonia: impact of age, comorbidity, and severity. Am J Respir Crit Care Med. 1999, 160: 397-405.","journal-title":"Am J Respir Crit Care Med"},{"key":"5541_CR18","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1164\/ajrccm.162.1.9907023","volume":"162","author":"F Arancibia","year":"2000","unstructured":"Arancibia F, Ewig S, Martinez JA, Ruiz M, Bauer T, Marcos MA, Mensa J, Torres A: Antimicrobial treatment failures in patients with community-acquired pneumonia: causes and prognostic implications. Am J Respir Crit Care Med. 2000, 162: 154-160.","journal-title":"Am J Respir Crit Care Med"},{"key":"5541_CR19","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1378\/chest.125.4.1335","volume":"125","author":"J Almirall","year":"2004","unstructured":"Almirall J, Bol\u00edbar I, Toran P, Pera G, Boquet X, Balanzo X, Sauca G: Contribution of C-reactive protein to the diagnosis and assessment of severity of community-acquired pneumonia. Chest. 2004, 125: 1335-1342. 10.1378\/chest.125.4.1335.","journal-title":"Chest"},{"key":"5541_CR20","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1183\/09031936.03.00080203","volume":"21","author":"E Garc\u00eda V\u00e1zquez","year":"2003","unstructured":"Garc\u00eda V\u00e1zquez E, Mart\u00ednez JA, Mensa J, S\u00e1nchez F, Marcos MA, de Roux A, Torres A: C-reactive protein levels in community-acquired pneumonia. Eur Respir J. 2003, 21: 702-705.","journal-title":"Eur Respir J"},{"key":"5541_CR21","doi-asserted-by":"publisher","first-page":"C241","DOI":"10.1590\/S1413-86702003000400003","volume":"7","author":"HI Requejo","year":"2003","unstructured":"Requejo HI, Cocoza AM: C-reactive protein in the diagnosis of community-acquired pneumonia. Braz J Infect Dis. 2003, 7: C241-244. 10.1590\/S1413-86702003000400003.","journal-title":"Braz J Infect Dis"},{"key":"5541_CR22","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s15010-005-4096-2","volume":"33","author":"N Boussekey","year":"2005","unstructured":"Boussekey N, Leroy O, Georges H, Devos P, d'Escrivan T, Guery B: Diagnostic and prognostic values of admission procalcitonin levels in community-acquired pneumonia in an intensive care unit. Infection. 2005, 33: 257-263. 10.1007\/s15010-005-4096-2.","journal-title":"Infection"},{"key":"5541_CR23","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1016\/S0140-6736(04)15591-8","volume":"363","author":"M Christ-Crain","year":"2004","unstructured":"Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, M\u00fcller B: Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet. 2004, 363: 600-607. 10.1016\/S0140-6736(04)15591-8.","journal-title":"Lancet"},{"key":"5541_CR24","doi-asserted-by":"publisher","first-page":"2043","DOI":"10.1378\/chest.123.6.2043","volume":"123","author":"SM Lobo","year":"2003","unstructured":"Lobo SM, Lobo FR, Bota DP, Lopes-Ferreira F, Soliman HM, M\u00e9lot C, Vincent JL: C-reactive protein levels correlate with mortality and organ failure in critically ill patients. Chest. 2003, 123: 2043-2049. 10.1378\/chest.123.6.2043.","journal-title":"Chest"}],"container-title":["Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/cc6105.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/cc6105\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/cc6105.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:34:52Z","timestamp":1728304492000},"score":1,"resource":{"primary":{"URL":"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/cc6105"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,8,28]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2007,8]]}},"alternative-id":["5541"],"URL":"https:\/\/doi.org\/10.1186\/cc6105","relation":{},"ISSN":["1364-8535"],"issn-type":[{"value":"1364-8535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,8,28]]},"assertion":[{"value":"5 June 2007","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 August 2007","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2007","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2007","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"R92"}}