Initial antimicrobial management of sepsis

Sepsis is a common consequence of infection, associated with a mortality rate > 25%. Although community-acquired sepsis is more common, hospital-acquired infection is more lethal. The most common site of infection is the lung, followed by abdominal infection, catheter-associated blood steam infec...

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Bibliographic Details
Published in:Critical care (London, England) England), 2021-08, Vol.25 (1), p.307-307, Article 307
Main Authors: Niederman, Michael S, Baron, Rebecca M, Bouadma, Lila, Calandra, Thierry, Daneman, Nick, DeWaele, Jan, Kollef, Marin H, Lipman, Jeffrey, Nair, Girish B
Format: Article
Language:English
Subjects:
Anti-Infective Agents - administration & dosage
Anti-Infective Agents - therapeutic use
Antibiotic therapy
Antibiotics
Antimicrobial agents
Antimicrobial therapy
Bacterial infections
Biomarkers
Biomarkers - analysis
Biomarkers - blood
Critical care
Diagnosis
Dosage and administration
Drug therapy
E coli
Fungal infection
Humans
Intra-abdominal infection
Microorganisms
Mortality
Pathogens
Patients
Pharmacokinetics
Pneumonia
Review
Sepsis
Sepsis - drug therapy
Staphylococcus infections
Streptococcus infections
Time Factors
Time-to-Treatment - standards
Time-to-Treatment - statistics & numerical data
Urinary tract infections
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Summary:Sepsis is a common consequence of infection, associated with a mortality rate > 25%. Although community-acquired sepsis is more common, hospital-acquired infection is more lethal. The most common site of infection is the lung, followed by abdominal infection, catheter-associated blood steam infection and urinary tract infection. Gram-negative sepsis is more common than gram-positive infection, but sepsis can also be due to fungal and viral pathogens. To reduce mortality, it is necessary to give immediate, empiric, broad-spectrum therapy to those with severe sepsis and/or shock, but this approach can drive antimicrobial overuse and resistance and should be accompanied by a commitment to de-escalation and antimicrobial stewardship. Biomarkers such a procalcitonin can provide decision support for antibiotic use, and may identify patients with a low likelihood of infection, and in some settings, can guide duration of antibiotic therapy. Sepsis can involve drug-resistant pathogens, and this often necessitates consideration of newer antimicrobial agents.
ISSN:1364-8535
1466-609X
1364-8535
1366-609X
DOI:10.1186/s13054-021-03736-w