Table 2: Summary of the studies in ICU patients with community-acquired (CAP) or ventilator-associated pneumonia (VAP).

StudiesTypes of patients includedConclusionsRemarks

Póvoa et al. [20]48 patients with VAP
CRP levels were higher than in noninfected patients. (i) No relationship with mortality was reported.
(ii) No comparisons of CRP between patients with VAP compared to other infections

Hillas et al. [35]45 patients with VAP(i) No difference in CRP concentrations at VAP diagnosis between survivors and nonsurvivors
(ii) Increase in CRP between days 1 and 7 increased the risk of developing septic shock
Long delay (7 days) for the diagnosis of inappropriate antibiotherapy

Seligman et al. [36]75 patients with VAP(i) No difference of CRP at admission between survivors and non survivors
(ii) Decreased delta CRP between day 4 to 0 was associated with survival
No difference in outcome between patients with appropriate and inappropriate antibiotherapy

Póvoa et al. [37]47 patients with VAP
By day 4, a CRP of 0.6 times the initial level was a marker of poor outcome
Importance of the CRP patterns at day 4 on outcome (fast response, nonresponse
or biphasic response)

Coelho et al. [38]53 patients with CAPBy day 3 a CRP level 0.5 times the initial level was a marker of poor outcomeImportance of the CRP patterns at day 3 on outcome (fast response, nonresponse
or biphasic response)

Coelho et al. [39]191 patients with CAP, 111 with mechanical ventilation(i) No difference in CRP levels at admission between survivors and non-survivors
(ii) CRP ratio (Day 7/Day 1) decreased significantly more rapidly in survivors
(i) Already at day 5, a CRP of above 0.5 of the baseline value was associated with a poor outcome.
(ii) Same results for patients with CAP with mechanical ventilation.

Bajwa et al. [40]
177 patients with ARDS/ALI(i) Lower CRP concentrations in non survivors compared to survivors
(ii) Difference in CRP was observed in
patients with pneumonia but not in trauma patients
Nonsurvivors who had a higher APACHE 3 score and were older and more cirrhotic were included in this group

Lisboa et al. [41] 68 ICU patients with VAP Good correlation between the first bacterial load and CRP concentrations and between variations of bacterial load and CRP over time (i) Relationship between bacterial burden and CRP
(ii) A CRP ratio of 0.8 at 96 hours seems to
be a useful indicator of adequate antibiotherapy

Bruns et al. [42]289 patients with CAP, 137 with bacterial etiology
A decline of LESS than 60% in CRP levels in 3 days and a decline of LESS of 90% in CRP levels in 7 days were both associated with an increased risk of having received inappropriate empiric antibiotic treatment Importance of the CRP patterns at days 3 and 5 on outcome (fast response, nonresponse,
or biphasic response)

Menendez et al. [43]658 patients with CAP(i) CRP levels were higher in patients with CAP with an isolated microorganism than without
(ii) CRP levels were significantly higher if CAP was associated with bacteremia
(iii) No really great differences appears for CRP in relation to the type of causal microorganisms
Relation between causal microorganisms and CRP