Considerations for Empiric Antimicrobial Therapy in Sepsis and Septic Shock in an Era of Antimicrobial Resistance

Patients with sepsis present across a spectrum of infection sites and severity of illnesses requiring complex decision making at the bedside as to when prompt antibiotics are indicated and which regimen is warranted. Many hemodynamically stable patients with sepsis and low acuity of illness may bene...

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Bibliographic Details
Published in:The Journal of infectious diseases 2020-07, Vol.222 (Suppl 2), p.S119-S131
Main Authors: Strich, Jeffrey R, Heil, Emily L, Masur, Henry
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - adverse effects
Anti-Bacterial Agents - therapeutic use
Antimicrobial Stewardship
Drug Resistance, Bacterial
Empirical Research
Humans
Inappropriate Prescribing
Sepsis - drug therapy
Shock, Septic - drug therapy
Supplement
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Summary:Patients with sepsis present across a spectrum of infection sites and severity of illnesses requiring complex decision making at the bedside as to when prompt antibiotics are indicated and which regimen is warranted. Many hemodynamically stable patients with sepsis and low acuity of illness may benefit from further work up before initiating therapy, whereas patients with septic shock warrant emergent broad-spectrum antibiotics. The precise empiric regimen is determined by assessing patient and epidemiological risk factors, likely source of infection based on presenting signs and symptoms, and severity of illness. Hospitals should implement quality improvement measures to aid in the rapid and accurate diagnosis of septic patients and to ensure antibiotics are given to patients in an expedited fashion after antibiotic order.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jiaa221