{
  "abstract": "Objectives Hospital guidance states that the minimum retesting interval (MRI) for C-reactive protein (CRP) is 48 hours. CRP is tested to detect and monitor the acute phase response, especially in infection. It is noted to rise about 12 hours after initial insult and peaks at around 48 hours. An MRI rejection rule has been demonstrated to be a safe and effective method to control CRP usage. However, clinicians may complete an override form, which is processed automatically, if they feel the rejection is clinically inappropriate. CRP is available without MRI in certain clinical test profiles, for some users and some locations e.g. paediatrics.Aims To review the change in CRP concentrations in those repeated within the 48-hour interval.To evaluate whether overriding the MRI appears appropriate, when done, and if the ruling requires modification or is safe.To evaluate whether CRP is being over-tested in hospitals.Method A random selection of override forms were obtained from December 2024. Each form included the patient‘s details and the reason for requiring the tests within the MRI. The CRP concentrations (initial and repeat), time between the tests (in hours) and details from the override forms were entered into Excel. The patient portal was used for result collection.Results Sixteen CRP override MRI forms were reviewed, concentrations are plotted for those which were <48 hours. Among the 12 patients, only one patient was revealed to have a significant increase in their CRP result, which was a post-operative patient. Three patients showed a reduction in their CRP while the rest of the patients had minor changes in their subsequent CRP results. Although outside study aims, presents data for the other patients who had their CRP repeated but specimens were over the MRI. Samples were taken between 48–72 hours after the initial blood results. Again, three out of four patients had no drastic shifts to their CRP values. As for the reasoning for repeat testing within the MRI (for 16 forms), half indicated that these tests were required to support their management (e.g. changing antibiotic route) or discharge planning. While a quarter was for suspected infection.Conclusions The results demonstrated that there were no substantial differences between the initial and repeated CRP values within the minimum retesting interval (nor even out with 48 hours). This supports the safety of this demand management technique and agrees with the literature. Furthermore, CRP is not routinely used as a diagnostic marker in septic screening thus, does not require urgent additional testing within 48 hours. Nor is the changing of antibiotics guided by CRP but patient ability to swallow and clinical markers of sepsis. Due to delay in resolution it is a poor biomarker for assessing fitness for discharge. To conclude, the results indicate that there is limited clinical value for repetitive testing for CRP in hospitals and a 48 hour MRI is appropriate and safe.",
  "authors": [
    {
      "affiliations": [
        "University Hospitals Sussex NHS Foundation Trust, Chichester, UK"
      ],
      "name": "Yanisa Taechameekietichai"
    },
    {
      "affiliations": [
        "University Hospitals Sussex NHS Foundation Trust, Chichester, UK"
      ],
      "name": "Kate E Shipman"
    }
  ],
  "title": "106 An audit for repeating CRP within 48 hours of initial request in an UK district teaching hospital",
  "uid": "5b8f159f-3a03-51a6-a7ee-56fcdbc1b141"
}