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Appropriate Antimicrobial Therapy for Sepsis
- In previous pearls, we have discussed the importance of early antimicrobial administration for patients with sepsis.
- In patients with septic shock, current guidelines recommend empiric antimicrobial therapy be initiated within 1 hour.
- Equally as important as early administration is the selection of appropriate antimicrobial therapy (i.e. choosing an antibiotic that is effective against the presumed or identified pathogen).
- In one of the most recent studies, investigators found a 5-fold reduction in survival (52% vs. 10.3%) between patients who received appropriate antibiotics compared to those who received antibiotics that were ineffective against the identified pathogen.
- In fact, choosing the right antibiotic is one of the strongest factors associated with patient outcome in sepsis.
- When selecting empiric antimicrobial therapy for patients with septic shock consider patient history, co-morbidities, the clinical site of infection, and local resistance data.
References
Kumar A, Ellis P, Arabi Y, et al. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest 2009; 136:1237-48.