Assessment of Antibiotics Duration by Serum C-Reactive Protein in patients with Liver Abscess

Aim: To assess the antibiotics duration by serum C -reactive protein in patients with liver abscess. Methods: The cross sectional study was conducted on patients presented with ultrasound proven liver abscess at tertiary care Hospital Jamshoro / Hyderabad during January 2019 to April 2019. The inclusion criteria of the study were large sized or partially liquefied hepatic abscess (>= 5cm in diameter), underwent percutaneous abscess drainage when the fluid is identified during ultrasonography and have been effective antibiotic treatment after percutaneous drainage. The duration of antibiotics and percutaneous drainage was observed while the C-reactive protein was also estimated to follow-up the treatment response. All patients had their baseline serum CRP levels tested on the day of abscess drainage followed by the repeated on 3rd and 7th day while the total number (in days) taken for the CRP value to normalize (<10mg/L) was also recorded. Results: All patients completed the entire duration study which included a follow up period of six months. Total fifty patients with liver abscess were studied and followed up. The most common age group in present study was 40 to 49 years accounting for 75% of patients with mean age +/- SD was 49.83 +/- 6.62 followed by 30 to 39 years accounting for 20% of the patients. The male and female population observed as 35(70%) and 15(30%). The frequency observed for pyogenic and amoebic liver abscess as 10 and 30 patients. All patients received intravenous antibiotics for duration of at least two weeks and continued further as per response observed. All patients had their baseline serum CRP levels tested on the day of abscess drainage followed by the repeated on 3rd and 7th day while the total number (in days) taken for the CRP value to normalize (<10mg/L) was also recorded and found to be as 25.62 +/- 6.52 while the mean +/- SD for antibiotic duration was 23.61 +/- 3.21. Conclusion: CRP is an acute phase reactant and is a valuable tool to estimate the duration of antibiotic therapy in liver abscess results in reducing additional costs of prolonged antibiotic therapy and antibiotic resistance.