C-reactive protein as an inflammatory marker in monitoring therapy effectiveness of acute odontogenic infections

Abstract

Introduction. Clinical presentation of acute odontogenic infections may vary, while adequate evaluation of its severity is of great importance for determination of appropriate and effective therapy. Objective. The aim of the present study was to monitor changes of C-reactive protein (CRP) levels, to correlate its values with symptoms of different acute odontogenic infections (AOI), and to monitor the effectiveness of the applied therapy. Methods. Fifty-four patients with AOI were included in the study. Eighteen patients with good drainage and normal body temperature were treated only by surgical incision without using antibiotics. Twenty-two patients with poor drainage after incision and normal body temperature were treated by surgical incision and antibiotics. Fourteen patients with elevated body temperature were treated by incision and antibiotics, irrespective of the quality of the drainage. CRP levels were measured on admission, on the 3rd and 7th day after therapy initiation. Results. On admission CRP levels were higher in AOI with elevated body temperature compared to poorly and well-drained AOI. There were no differences in CRP levels between well and poorly drained AOI on admission. On the 3rd day, a decline in the CRP levels was evident in all three groups of patients, and there was no difference among the groups. On the 7th day, the CRP levels normalized in all groups. Conclusion. CRP levels correlate well with the severity and resolution of AOI and could be used as a reliable parameter in monitoring the effectiveness of AOI therapy.

Uvod. Klinička slika akutne dentogene infekcije (ADI) je raznolika, a pravilna procena težine ADI od velikog značaja za određivanje odgovarajuće i efikasne terapije. Cilj rada. Cilj rada je bio da se uporede vrednosti i promene nivoa C-reaktivnog proteina (CRP) s kliničkim simptomima ADI različitog stepena težine tokom lečenja bolesnika, te na taj način utvrdi efikasnost primenjene terapije. Metode rada. Istraživanjem su obuhvaćena 54 pacijenta sa ADI. Osamnaest pacijenata sa dobrom drenažom nakon incizije i normalnom telesnom temperaturom lečeno je bez antibiotika. Dvadeset dva pacijenta s lošom drenažom nakon incizije i normalnom telesnom temperaturom lečena su incizijom i antibioticima. Četrnaest pacijenata s povišenom telesnom temperaturom lečeno je incizijom i antibioticima bez obzira na kvalitet drenaže. Nivo CRP je meren na prijemu, trećeg i sedmog dana od početka primene terapije. Rezultati. Na početku lečenja nivo CRP bio je veći kod bolesnika s povišenom telesnom temperaturom u poređenju s ostalim ispitanicima. Na početku lečenja nije bilo razlike u nivou CRP između ispitanika sa dobrom i lošom drenažom. Trećeg dana uočeno je smanjenje nivoa CRP u sve tri grupe ispitanika bez ikakve razlike. Sedmog dana nivo CRP se normalizovao u svim grupama. Zaključak. Nivo CRP je u dobroj korelaciji sa stepenom težine i povlačenjem dentogene infekcije, tako da može biti pouzdan parametar u proceni efikasnosti lečenja ADI.