The relationship between neutrophil-lymphocyte ratio and antibiotic therapy in patients with fever of unknown origin

Year 2021, Volume: 11 Issue: 1, 25 - 31, 22.03.2021

Cengiz Karacaer , Oğuz Karabay , Ali Tamer

https://doi.org/10.31832/smj.813151

Abstract

Amaç: Ampirik antibiyotik tedavisi, enfeksiyon kaynağınınhenüzbelirlenemediğidurumlardahekimlerinateşiolanhastalarayaygınolarakuyguladıklarıbiryöntemdir.Bu çalışmanın amacı, nedeni bilinmeyen ateşi olan hastalarda (NBA) ampirikantibiyotiktedavisindemaliyet-etkininflamatuarparametreleribelirlemektir.
GereçveYöntemler: KankültürlerialınmışolanNBA iletakipedilentoplam 577 hasta enfeksiyonabağlıateşgrubu (EBAG,n:203) veenfeksiyonabağlıolmayanateşgrubu (EBOAG,n:374) olarakikigrubaayrıldıvebeşyıllıkverileri hasta bilgikayıtsistemindengeriyedönükolarakincelendi. Tam kan test sonuçlarından nötrofil sayısı, lenfosit sayısı parametresine oranlanarak nötrofil lenfosit oranı ve trombosit lenfosit oranı değerleri hesaplandı.
Bulgular: Toplam 577 hasta enfeksiyonabağlıateşgrubu (EBAG) veenfeksiyonabağlıolmayanateşgrubu (EBOAG) olarakikigrubaayrıldı. İlk antibiyotikkullanımsüreleri EBAG veEBOAG'dasırasıyla 4.54 ± 3.08 (1-14)günve 5.35 ± 3.8 (1–21)gündü(p = 0.023). Nötrofil-lenfositoranı (NLO) EBAG’da 8.00 (3.00-15.00)iken, EBOAG’da 5.00 (3.00-9.00)idi (p = 0.001). Trombosit-lenfositoranı (TLO) EBAG’da 21.00(9.00-41.00)iken, EBOAG’da 16.00 (7.25-27.75)idiveanlamlıdeğildi (p = 0.165).
Sonuç:Nötrofillenfositoranırutinkantestlerindenbakılabilenvepahalıbiryöntemolmamasınedeniyle, nedenibelirlenemeyenateşli (NBA)hastalardaavantajlıbirtanımetoduolarakkullanılabilir.

Keywords

Ampirik Antibiyotik Tedavisi, Nedeni Bilinmeyen Ateş, Nötrofil Lenfosit Oranı, Trombosit Lenfosit Oranı

The relationship between neutrophil-lymphocyte ratio and antibiotic therapy in patients with fever of unknown origin

Abstract

Objective: Empirical antibiotic therapy is usually applied by physicians to patients with fever when the origin of the infection cannot yet be determined.The aim of this study is to determine the cost-effectiveinflammatoryparametersin empirical antibiotic therapy in patients with fever of unknown origin(FUO).
Materials and Methods:A total of 577 patients, whose blood cultures were taken and followed up by the NBA, were divided into two groups as fever group due to infection(IRFG) and fever group not related to infection(NIRFG), and their five-year data were analyzed retrospectively from the patient information registry system.From the complete blood count test results, the neutrophil count was proportioned to the lymphocyte count parameter, and the neutrophil lymphocyte ratio and thrombocyte lymphocyte ratio values were calculated.
Results: Total of 577 patients were divided into two groups as infection related fever group (IRFG) and non-infection related fever group (NIRFG), and were included in the study. The durations of first antibiotic usages were 4.54 ± 3.08(1–14) days and 5.35 ± 3.8(1–21) days in IRFG and NIRFG, respectively. Neutrophil-to-lymphocyte ratio (NLR) was 8.00 (3.00-15.00) in the IRFG, whereas it was 5.00 (3.00-9) in the NIRFG (p = 0.001). Platelet-to-lymphocyte ratio (PLR) was 21.00 (9.00-41.00) in the IRFG, whereas it was 16.00 (7.25-27.75) in the NIRFG and was not significant (p = 0.165).
Conclusion:Since neutrophil-lymphocyte ratio can be checked from routine blood tests and is not an expensive method, it can be used as an advantageous diagnostic method in patients with fever of unknown origin(FUO).

Keywords

Empirical antibiotic therapy, Fever of unknown origin, Neutrophil to lymphocyte ratio, Platelet-to-lymphocyte ratio

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