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The usefulness of appetite and energy intake-based algorithms to assess treatment effect of a bacterial infection : An observational prospective study

Peny, Viktor; Månsson, Fredrik LU ; Resman, Fredrik LU ; Ahl, Jonas LU and Tham, Johan LU (2017) In PLoS ONE 12(10).
Abstract

Background: The diagnosis of infectious diseases and the duration of antibiotic therapies are generally based on empirical rules. Studies implicate that the use biological markers can be used as a reliable method to shorten antibiotic therapies. The return of appetite is a clinical aspect of recovery from an infection that may be used to guide antibiotic therapies. Objective: To compare changes in appetite and daily energy intake with changes in CRP-levels in patients recovering from an infection. Design: Observational study using a consecutive sample of patients admitted to the unit for infectious diseases at a University Hospital in Sweden, February to April 2014. ... (More)

Background: The diagnosis of infectious diseases and the duration of antibiotic therapies are generally based on empirical rules. Studies implicate that the use biological markers can be used as a reliable method to shorten antibiotic therapies. The return of appetite is a clinical aspect of recovery from an infection that may be used to guide antibiotic therapies. Objective: To compare changes in appetite and daily energy intake with changes in CRP-levels in patients recovering from an infection. Design: Observational study using a consecutive sample of patients admitted to the unit for infectious diseases at a University Hospital in Sweden, February to April 2014. Energy intake, CRP-levels and appetite were recorded daily. Energy intake was calculated using estimated energy contents. Appetite was measured using a validated visual analogue scale. Changes in daily energy intakes, CRP-levels and appetite were analysed. Results: 49 patients (51% men) were included in the analysis from the overall population of 256 patients. During the length of the stay (median 3 days) CRP-levels fell in 92% of the patients (p<0.001), daily energy intake increased in 73% (median intake +6381 kJ/day, p<0.001) and appetite increased in 55% of the patients (p = 0.181). VAS-estimations of appetite augmented in 55%, decreased in 41% and were equal in 5% of the patients (p = 0.181). There was a non-significant difference in the within-subject variances in daily energy intake between female and male patients but not in other subsets. Conclusions: We found a significantly increase in the daily energy intake but not in self-estimated appetite in patients recovering from an infection. We suggest measuring the daily energy intake as a complement to other biological and clinical markers among inpatients to assess treatment effect.

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author
organization
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type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
12
issue
10
publisher
Public Library of Science
external identifiers
  • scopus:85032449767
  • wos:000413845400028
ISSN
1932-6203
DOI
10.1371/journal.pone.0186514
language
English
LU publication?
yes
id
2e4e77c8-a2e5-4f4e-af2e-d54e4f549afd
date added to LUP
2017-11-07 14:09:12
date last changed
2018-02-07 15:03:51
@article{2e4e77c8-a2e5-4f4e-af2e-d54e4f549afd,
  abstract     = {<p>Background: The diagnosis of infectious diseases and the duration of antibiotic therapies      are      generally based on empirical rules. Studies implicate that the use biological      markers      can be used as a reliable method to shorten antibiotic therapies. The return      of      appetite is a clinical aspect of recovery from an infection that may be used to      guide      antibiotic therapies. Objective: To compare changes in appetite and daily energy      intake      with changes in CRP-levels in patients recovering from an infection. Design: Observational      study using a consecutive sample of patients admitted to the unit for      infectious      diseases at a University Hospital in Sweden, February to April 2014.      Energy      intake, CRP-levels and appetite were recorded daily. Energy intake was calculated      using      estimated energy contents. Appetite was measured using a validated visual analogue      scale.      Changes in daily energy intakes, CRP-levels and appetite were analysed. Results:      49      patients (51% men) were included in the analysis from the overall population of      256      patients. During the length of the stay (median 3 days) CRP-levels fell in 92%      of      the patients (p&lt;0.001), daily energy intake increased in 73% (median intake      +6381      kJ/day, p&lt;0.001) and appetite increased in 55% of the patients (p = 0.181).      VAS-estimations      of appetite augmented in 55%, decreased in 41% and were equal in      5% of the      patients (p = 0.181). There was a non-significant difference in the within-subject      variances      in daily energy intake between female and male patients but not in other      subsets.      Conclusions:      We      found a significantly increase in the daily energy intake but not in self-estimated      appetite      in patients recovering from an infection. We suggest measuring the daily      energy      intake as a complement to other biological and clinical markers among inpatients      to      assess treatment effect.</p>},
  articleno    = {e0186514},
  author       = {Peny, Viktor and Månsson, Fredrik and Resman, Fredrik and Ahl, Jonas and Tham, Johan},
  issn         = {1932-6203},
  language     = {eng},
  month        = {10},
  number       = {10},
  publisher    = {Public Library of Science},
  series       = {PLoS ONE},
  title        = {The usefulness of appetite and energy intake-based algorithms to assess treatment effect of a bacterial infection : An observational prospective study},
  url          = {http://dx.doi.org/10.1371/journal.pone.0186514},
  volume       = {12},
  year         = {2017},
}