Serial C- reactive protein measurement significance in neonatal sepsis management

Background: Neonatal sepsis is a significant cause of death globally, yet diagnosis is challenging due to delayed culture results. Alternatively, C-reactive protein (CRP) is a widely available diagnostic test with fast, accurate, and reliable results. Objective: To assess the diagnostic accuracy of the first CRP reading (10 mg/L was considered positive. The second CRP served as the reference. Sensitivity, specificity, predictive values, and impact on treatment decisions were evaluated. Results: this paper included 120 infants, The initial CRP had an overall accuracy of only roughly 72%, with sensitivity of 23%, specificity of 93%, PPV of 60%, and NPV of 72%. In 28% of cases, inaccurate early CRP readings resulted in possible therapy modifications. Conclusion: Although specific and predictive of infection, single early CRP without repetition is non sensitive and if not repeated cannot be used to screen for early neonatal sepsis or to rule out infection. Serial CRP testing improves diagnostic confidence and should be incorporated into neonatal sepsis evaluation, particularly when initial results are negative.