Welkom bij Scalda & Bohn Stafleu van Loghum
Scalda heeft ervoor gezorgd dat je Mijn BSL eenvoudig en snel kunt raadplegen.Je kunt de producten hieronder links aanschaffen en rechts inloggen.
01-04-2006 | Onderzoek
Waarde CRP bij diagnostiek lageluchtweginfecties onzeker
Auteurs: Victor van der Meer, dr. Arie Knuistingh Neven, prof.dr. Peterhans van den Broek, prof.dr. Pim Assendelft
Log in om toegang te krijgenshare
DELEN
Deel dit onderdeel of sectie (kopieer de link)
-
Optie A:
-
Optie B:Deel de link per e-mail
samenvatting
Van der Meer V, Knuistingh Neven A, Van den Broek PJ, Assendelft WJJ. Waarde CRP bij diagnostiek lageluchtweginfecties onzeker. Huisarts Wet 2006;49(4):192-7.
Doel Het bepalen van de diagnostische waarde van C-reactief proteïne (CRP) bij de detectie van een pneumonie en bij het onderscheiden van een bacteriële en virale lageluchtweginfectie.
Methoden Een systematisch literatuuronderzoek in PubMed en EMBASE. We includeerden onderzoeken waarin CRP werd vergeleken met een thoraxfoto of met microbiologisch onderzoek als referentietest.
Resultaten Geen van de onderzoeken voldeed aan alle validiteitscriteria. Zes onderzoeken hadden een thoraxfoto als referentietest. De sensitiviteit varieerde van 10% tot 98% en de specificiteit van 44% tot 99%. In een subgroep van volwassenen (5 onderzoeken) bedroeg de oppervlakte onder de ROC-curve 0,80 (95%-BI 0,75-0,85). Twaalf onderzoeken betroffen de relatie van CRP met een bacteriële oorsprong van een lageluchtweginfectie. Deze gegevens waren epidemiologisch en statistisch heterogeen.
Conclusie C-reactief proteïne is onvoldoende sensitief en specifiek om een pneumonie of een bacteriële oorsprong van een lageluchtweginfectie aan te tonen dan wel uit te sluiten. Het meeste diagnostische onderzoek is methodologisch van matige kwaliteit. De huidige onderzoeken ondersteunen het voorschrijven van antibiotica op basis van CRP bij lageluchtweginfecties in de huisartsenpraktijk niet. De resultaten bevestigen het advies in de huidige NHG-Standaard Acuut hoesten: CRP heeft geen bewezen aanvullende waarde bij de diagnostiek van lageluchtweginfecties.
Log in om toegang te krijgen
Literatuur
go back to reference Smucny JJ, Becker LA, Glazier RH, McIsaac W. Are antibiotics effective treatments for acute bronchitis? A meta-analysis. J Fam Pract 1998;47:453-60.PubMed
Smucny JJ, Becker LA, Glazier RH, McIsaac W. Are antibiotics effective treatments for acute bronchitis? A meta-analysis. J Fam Pract 1998;47:453-60.PubMed
go back to reference Hjortdahl P, Landaas S, Urdal P, Steinbakk M, Fuglerud P, Nygaard B. C-reactive protein: a new rapid assay for managing infectious disease in primary health care. Scand J Prim Health Care 1991;9:3-10.CrossRefPubMed
Hjortdahl P, Landaas S, Urdal P, Steinbakk M, Fuglerud P, Nygaard B. C-reactive protein: a new rapid assay for managing infectious disease in primary health care. Scand J Prim Health Care 1991;9:3-10.CrossRefPubMed
go back to reference Hopstaken RM, Muris JWM, Knottnerus JA, Kester ADM, Rinkens PELM, Dinant GJ. De waarde van anamnese, lichamelijk onderzoek, BSE en CRP voor de diagnose pneumonie bij acute lage-luchtweginfecties. Huisarts Wet 2004;47:9-15.CrossRef
Hopstaken RM, Muris JWM, Knottnerus JA, Kester ADM, Rinkens PELM, Dinant GJ. De waarde van anamnese, lichamelijk onderzoek, BSE en CRP voor de diagnose pneumonie bij acute lage-luchtweginfecties. Huisarts Wet 2004;47:9-15.CrossRef
go back to reference Graffelman AW, Knuistingh Neven A, Le Cessie S, Kroes ACM, Van den Broek PJ. Bacterieel of viraal? Een eenvoudig diagnostisch hulpmiddel bij lageluchtweginfecties. Huisarts Wet 2005;48:48-53.
Graffelman AW, Knuistingh Neven A, Le Cessie S, Kroes ACM, Van den Broek PJ. Bacterieel of viraal? Een eenvoudig diagnostisch hulpmiddel bij lageluchtweginfecties. Huisarts Wet 2005;48:48-53.
go back to reference Verheij ThJM, Salomé PhL, Bindels PJ, Chavannes AW, Ponsioen BP, Sachs APE, et al. NHG-Standaard Acuut hoesten. Huisarts Wet 2003;46:496-506.
Verheij ThJM, Salomé PhL, Bindels PJ, Chavannes AW, Ponsioen BP, Sachs APE, et al. NHG-Standaard Acuut hoesten. Huisarts Wet 2003;46:496-506.
go back to reference Diederichsen HZ, Skamling M, Diederichsen A, Grinsted P, Antonsen S, Petersen PH, et al. [A randomized controlled trial of the use of CRP rapid test as a guide to treatment of respiratory infections in general practice.] Ugeskr Laeger 2001;163:3784-7. [Danish]PubMed
Diederichsen HZ, Skamling M, Diederichsen A, Grinsted P, Antonsen S, Petersen PH, et al. [A randomized controlled trial of the use of CRP rapid test as a guide to treatment of respiratory infections in general practice.] Ugeskr Laeger 2001;163:3784-7. [Danish]PubMed
go back to reference Midgette AS, Stukel TA, Littenberg B. A meta-analytic method for summarizing diagnostic test performances: receiver-operating-characteristic – summary point estimates. Med Decis Making 1993;13:253-7.CrossRefPubMed
Midgette AS, Stukel TA, Littenberg B. A meta-analytic method for summarizing diagnostic test performances: receiver-operating-characteristic – summary point estimates. Med Decis Making 1993;13:253-7.CrossRefPubMed
go back to reference Cochrane Methods Group on Systematic Review of Screening and Diagnostic Tests: Recommended Methods, updated 6 June 1996. http://www.cochrane.org/cochrane/sadtdoc1.htm.
Cochrane Methods Group on Systematic Review of Screening and Diagnostic Tests: Recommended Methods, updated 6 June 1996. http://www.cochrane.org/cochrane/sadtdoc1.htm.
go back to reference Devillé WL, Buntinx F, Bouter LM, Montori VM, De Vet HCW, Van der Windt DAWM, et al. Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Medical Research Methodology 2002;2:9.CrossRefPubMed
Devillé WL, Buntinx F, Bouter LM, Montori VM, De Vet HCW, Van der Windt DAWM, et al. Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Medical Research Methodology 2002;2:9.CrossRefPubMed
go back to reference Bachmann LM, Estermann P, Glanville J, Kronenberg C, Ter Riet G. Identifying diagnostic accuracy studies in EMBASE. J Med Libr Assoc 2003;91:341-6.PubMed
Bachmann LM, Estermann P, Glanville J, Kronenberg C, Ter Riet G. Identifying diagnostic accuracy studies in EMBASE. J Med Libr Assoc 2003;91:341-6.PubMed
go back to reference Lijmer JG, Mol BW, Heisterkamp S, Bonsel GJ, Prins MH, Van der Meulen JHP, et al. Empirical evidence of design-related bias in studies of diagnostic tests. JAMA 1999;282:1061-6.CrossRefPubMed
Lijmer JG, Mol BW, Heisterkamp S, Bonsel GJ, Prins MH, Van der Meulen JHP, et al. Empirical evidence of design-related bias in studies of diagnostic tests. JAMA 1999;282:1061-6.CrossRefPubMed
go back to reference Jüni P, Douglas GA, Egger M. Systematic review in health care: assessing the quality of controlled clinical trials. BMJ 2001;323:42-6.CrossRefPubMed
Jüni P, Douglas GA, Egger M. Systematic review in health care: assessing the quality of controlled clinical trials. BMJ 2001;323:42-6.CrossRefPubMed
go back to reference Koch H, Meerkerk GJ, Zaat JO, Ham MF, Scholten RJ, Assendelft WJJ. Accuracy of carbohydrate-deficient transferrin in the detection of excessive alcohol consumption: a systematic review. Alcohol Alcohol 2004;39:75-85.PubMed
Koch H, Meerkerk GJ, Zaat JO, Ham MF, Scholten RJ, Assendelft WJJ. Accuracy of carbohydrate-deficient transferrin in the detection of excessive alcohol consumption: a systematic review. Alcohol Alcohol 2004;39:75-85.PubMed
go back to reference Flanders SA, Stein J, Shochat G, Sellers K, Holland M, Maselli J, et al. Performance of a bedside C-reactive protein test in the diagnosis of community-acquired pneumonia in adults with acute cough. Am J Med 2004;116:529-35.CrossRefPubMed
Flanders SA, Stein J, Shochat G, Sellers K, Holland M, Maselli J, et al. Performance of a bedside C-reactive protein test in the diagnosis of community-acquired pneumonia in adults with acute cough. Am J Med 2004;116:529-35.CrossRefPubMed
go back to reference Almirall J, Bolibar I, Toran P, Pera G, Boquet X, Balanzo X, et al. Contribution of C-reactive protein to the diagnosis and assessment of severity of community-acquired pneumonia. Chest 2004;125:1335-42.CrossRefPubMed
Almirall J, Bolibar I, Toran P, Pera G, Boquet X, Balanzo X, et al. Contribution of C-reactive protein to the diagnosis and assessment of severity of community-acquired pneumonia. Chest 2004;125:1335-42.CrossRefPubMed
go back to reference Hopstaken RM, Muris JW, Knottnerus JA, Kester AD, Rinkens PE, Dinant GJ. Contributions of symptoms, signs, erythrocyte sedimentation rate, and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection. Br J Gen Pract 2003;53:358-64.PubMed
Hopstaken RM, Muris JW, Knottnerus JA, Kester AD, Rinkens PE, Dinant GJ. Contributions of symptoms, signs, erythrocyte sedimentation rate, and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection. Br J Gen Pract 2003;53:358-64.PubMed
go back to reference Melbye H, Straume B, Brox J. Laboratory tests for pneumonia in general practice: the diagnostic values depend on the duration of illness. Scand J Prim Health Care 1992;10:234-40.CrossRefPubMed
Melbye H, Straume B, Brox J. Laboratory tests for pneumonia in general practice: the diagnostic values depend on the duration of illness. Scand J Prim Health Care 1992;10:234-40.CrossRefPubMed
go back to reference Babu G, Ganguly NK, Singhi S, Walia BNS. Value of C-reactive protein concentration in diagnosis and management of acute lower respiratory infections. Trop Geogr Med 1989;41:309-15.PubMed
Babu G, Ganguly NK, Singhi S, Walia BNS. Value of C-reactive protein concentration in diagnosis and management of acute lower respiratory infections. Trop Geogr Med 1989;41:309-15.PubMed
go back to reference Melbye H, Straume B, Aasebo U, Brox J. The diagnosis of adult pneumonia in general practice. Scand J Prim Health Care 1988;6:111-7.CrossRefPubMed
Melbye H, Straume B, Aasebo U, Brox J. The diagnosis of adult pneumonia in general practice. Scand J Prim Health Care 1988;6:111-7.CrossRefPubMed
go back to reference Prat C, Dominguez J, Rodrigo C, Gimenez M, Azuara M, Jimenez O, et al. Procalcitonin, C-reactive protein and leukocyte count in children with lower respiratory tract infection. Pediatr Infect Dis J 2003;22:963-8.CrossRefPubMed
Prat C, Dominguez J, Rodrigo C, Gimenez M, Azuara M, Jimenez O, et al. Procalcitonin, C-reactive protein and leukocyte count in children with lower respiratory tract infection. Pediatr Infect Dis J 2003;22:963-8.CrossRefPubMed
go back to reference Requejo HI, Cocoza AM. C-reactive protein in the diagnosis of community-acquired pneumonia. Braz J Infect Dis 2003;7:241-4.CrossRefPubMed
Requejo HI, Cocoza AM. C-reactive protein in the diagnosis of community-acquired pneumonia. Braz J Infect Dis 2003;7:241-4.CrossRefPubMed
go back to reference Garcia Vazquez E, Martinez JA, Mensa J, Sanchez F, Marcos MA, De Roux A, et al. C-reactive protein levels in community-acquired pneumonia. Eur Respir J 2003;21:702-5.CrossRefPubMed
Garcia Vazquez E, Martinez JA, Mensa J, Sanchez F, Marcos MA, De Roux A, et al. C-reactive protein levels in community-acquired pneumonia. Eur Respir J 2003;21:702-5.CrossRefPubMed
go back to reference Virkki R, Juven T, Rikalainen H, Svedstrom E, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children. Thorax 2002;57:438-41.CrossRefPubMed
Virkki R, Juven T, Rikalainen H, Svedstrom E, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children. Thorax 2002;57:438-41.CrossRefPubMed
go back to reference Hedlund J, Hansson LO. Procalcitonin and C-reactive protein levels in community-acquired pneumonia: correlation with etiology and prognosis. Infection 2000;28:68-73.CrossRefPubMed
Hedlund J, Hansson LO. Procalcitonin and C-reactive protein levels in community-acquired pneumonia: correlation with etiology and prognosis. Infection 2000;28:68-73.CrossRefPubMed
go back to reference Heiskanen-Kosma T, Korppi M. Serum C-reactive protein cannot differentiate bacterial and viral aetiology of community-acquired pneumonia in children in primary healthcare settings. Scand J Infect Dis 2000;32:399-402.CrossRefPubMed
Heiskanen-Kosma T, Korppi M. Serum C-reactive protein cannot differentiate bacterial and viral aetiology of community-acquired pneumonia in children in primary healthcare settings. Scand J Infect Dis 2000;32:399-402.CrossRefPubMed
go back to reference Nohynek H, Valkeila E, Leinonen M, Eskola J. Erythrocyte sedimentation rate, white blood cell count and serum C-reactive protein in assessing etiologic diagnosis of acute lower respiratory infections in children. Pediatr Infect Dis J 1995;14:484-90.CrossRefPubMed
Nohynek H, Valkeila E, Leinonen M, Eskola J. Erythrocyte sedimentation rate, white blood cell count and serum C-reactive protein in assessing etiologic diagnosis of acute lower respiratory infections in children. Pediatr Infect Dis J 1995;14:484-90.CrossRefPubMed
go back to reference Ortqvist A, Hedlund J, Wretlind B, Carlstrom A, Kalin M. Diagnostic and prognostic value of interleukin-6 and C-reactive protein in community-acquired pneumonia. Scand J Infect Dis 1995;27:457-62.CrossRefPubMed
Ortqvist A, Hedlund J, Wretlind B, Carlstrom A, Kalin M. Diagnostic and prognostic value of interleukin-6 and C-reactive protein in community-acquired pneumonia. Scand J Infect Dis 1995;27:457-62.CrossRefPubMed
go back to reference Korppi M, Kroger L. C-reactive protein in viral and bacterial respiratory infection in children. Scand J Infect Dis 1993;25:207-13.CrossRefPubMed
Korppi M, Kroger L. C-reactive protein in viral and bacterial respiratory infection in children. Scand J Infect Dis 1993;25:207-13.CrossRefPubMed
go back to reference Kerttula Y, Leinonen M, Koskela M, Makela PH. The aetiology of pneumonia. Application of bacterial serology and basic laboratory methods. J Infect 1987;14:21-30.CrossRefPubMed
Kerttula Y, Leinonen M, Koskela M, Makela PH. The aetiology of pneumonia. Application of bacterial serology and basic laboratory methods. J Infect 1987;14:21-30.CrossRefPubMed
go back to reference McCarthy PL, Frank AL, Ablow RC, Masters SJ, Dolan TF Jr. Value of the C-reactive protein test in the differentiation of bacterial and viral pneumonia. J Pediatr 1978;92:454-6.CrossRefPubMed
McCarthy PL, Frank AL, Ablow RC, Masters SJ, Dolan TF Jr. Value of the C-reactive protein test in the differentiation of bacterial and viral pneumonia. J Pediatr 1978;92:454-6.CrossRefPubMed
go back to reference Melbye H, Berdal BP, Straume B, Russell H, Vorland L, Thacker WL. Pneumonia – a clinical or radiographic diagnosis? Etiology and clinical features of lower respiratory tract infection in adults in general practice. Scand J Infect Dis 1992;24:647-55.CrossRefPubMed
Melbye H, Berdal BP, Straume B, Russell H, Vorland L, Thacker WL. Pneumonia – a clinical or radiographic diagnosis? Etiology and clinical features of lower respiratory tract infection in adults in general practice. Scand J Infect Dis 1992;24:647-55.CrossRefPubMed
go back to reference Hopstaken RM, Witbraad T, Van Engelshoven JMA, Dinant GJ. Inter-observer variation in the interpretation of chest radiographs for pneumonia in community-acquired lower respiratory tract infections. Clin Radiol 2004;59:743-52.CrossRefPubMed
Hopstaken RM, Witbraad T, Van Engelshoven JMA, Dinant GJ. Inter-observer variation in the interpretation of chest radiographs for pneumonia in community-acquired lower respiratory tract infections. Clin Radiol 2004;59:743-52.CrossRefPubMed
go back to reference Bartlett JG, Mundy LM. Community-acquired pneumnia. N Engl J Med 1995;333:1618-24.CrossRefPubMed
Bartlett JG, Mundy LM. Community-acquired pneumnia. N Engl J Med 1995;333:1618-24.CrossRefPubMed
go back to reference Boersma WG, Lowenberg A, Holloway Y, Kuttschrutter H, Snijder JA, Koeter GH. Pneumococcal capsular antigen detection and pneumococcal serology in patients with community acquired pneumonia. Thorax 1991;46:902-6.CrossRefPubMed
Boersma WG, Lowenberg A, Holloway Y, Kuttschrutter H, Snijder JA, Koeter GH. Pneumococcal capsular antigen detection and pneumococcal serology in patients with community acquired pneumonia. Thorax 1991;46:902-6.CrossRefPubMed
go back to reference Lim WS, Macfarlane JT, Boswell TCJ, Harrison TG, Rose D, Leinonen M, et al. Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines. Thorax 2001;56:296-301.CrossRefPubMed
Lim WS, Macfarlane JT, Boswell TCJ, Harrison TG, Rose D, Leinonen M, et al. Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines. Thorax 2001;56:296-301.CrossRefPubMed
go back to reference Lode H, Schaberg T, Raffenberg M, Mauch H. Diagnostic problems in lower respiratory tract infections. J Antimicrob Chemother 1993;Suppl A:29-37.
Lode H, Schaberg T, Raffenberg M, Mauch H. Diagnostic problems in lower respiratory tract infections. J Antimicrob Chemother 1993;Suppl A:29-37.
Metagegevens
- Titel
- Waarde CRP bij diagnostiek lageluchtweginfecties onzeker
- Auteurs
-
Victor van der Meer
dr. Arie Knuistingh Neven
prof.dr. Peterhans van den Broek
prof.dr. Pim Assendelft
- Publicatiedatum
- 01-04-2006
- Uitgeverij
- Bohn Stafleu van Loghum
- DOI
- https://doi.org/10.1007/BF03084703