De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock

This review concludes that there is no adequate, direct evidence as to whether de-escalation of antimicrobial agents is effective and safe for adults with sepsis, severe sepsis or septic shock. The authors say this uncertainty warrants further research via RCTs and the authors are awaiting the results of an ongoing RCT testing the de-escalation of empirical antimicrobial therapy for severe sepsis.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news

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Rapid diagnosis and appropriate treatment is imperative in bacterial sepsis due increasing risk of mortality with every hour without appropriate antibiotic therapy. Atypical infections with fastidious organism...
Source: BMC Infectious Diseases - Category: Infectious Diseases Authors: Tags: Case report Source Type: research
Publication date: October 2019Source: The Journal of Steroid Biochemistry and Molecular Biology, Volume 193Author(s): Thijs A. Wolf, Sunil J. Wimalawansa, Mohammed S. RazzaqueAbstractEarly diagnosis of sepsis is often difficult in clinical practice, whilst it can be vital for positive patient outcomes in sepsis management. Any delay in diagnosis and treatment may lead to significant organ failure and can be associated with elevated mortality rates. Early diagnosis and effective management of sepsis can allow for prompt antibiotic therapy and a potential reduction in mortality; it can also minimize the unnecessary use of an...
Source: The Journal of Steroid Biochemistry and Molecular Biology - Category: Biochemistry Source Type: research
Publication date: Available online 16 July 2019Source: The Journal of Steroid Biochemistry and Molecular BiologyAuthor(s): Thijs Wolf, Sunil J. Wimalawansa, Mohammed S. RazzaqueAbstractEarly diagnosis of sepsis is often difficult in clinical practice, whilst it can be vital for positive patient outcomes in sepsis management. Any delay in diagnosis and treatment may lead to significant organ failure and can be associated with elevated mortality rates. Early diagnosis and effective management of sepsis not only allows for prompt antibiotic therapy and a potential reduction in mortality, it can also minimize the unnecessary u...
Source: The Journal of Steroid Biochemistry and Molecular Biology - Category: Biochemistry Source Type: research
AbstractBackgroundAlthough previous studies showed an increasing prevalence of infections due to multi-drug resistant (MDR) bacteria in the community, specific data on sepsis are lacking. We aimed to assess prevalence, risk factors and outcomes of patients with sepsis due to MDR bacteria.MethodsAn observational, retrospective study was conducted on consecutive adult patients coming from the community and admitted to the Policlinico Hospital, Milan, Italy, with a diagnosis of sepsis between January 2011 and December 2015. Primary study outcome was in-hospital mortality.ResultsAmong 518 patients, at least one MDR bacteria wa...
Source: Multidisciplinary Respiratory Medicine - Category: Respiratory Medicine Source Type: research
ConclusionsEfficient treatment of severe anaerobic sepsis resulting from descending necrotizing mediastinitis should build on a multidisciplinary approach. In support of first-line therapies with targeted antibiotics and surgical debridement, clinicians should consider alternative therapies such as continuous venovenous hemodiafiltration with cytokine-adsorbing hemofilters and hyperoxygenation.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
We report a case of a 40-year-old immunocompetent woman who presented with pneumonia and septic shock secondary to A. hydrophila infection. Her clinical course was complicated by acute respiratory distress syndrome, metabolic acidosis, and multiorgan failure resulting in mortality. The isolate was susceptible to third-generation and fourth-generation cephalosporins, piperacillin-tazobactam, fluoroquinolones, and trimotheprim/sulfamethoxazole. Review of the literature for previous reports of infection with Aeromonas species infection in previously healthy individuals suggests that pneumonia and bacteremia due to A. hydrophi...
Source: Clinical Pulmonary Medicine - Category: Respiratory Medicine Tags: Respiratory Infections Source Type: research
Abstract Delayed antimicrobial therapy is associated with poor outcomes in sepsis, but the optimal antibiotic administration time remains unclear. We aimed to investigate the effects of the time of antimicrobial administration on outcomes and evaluate an optimal empiric antibiotic administration time window for children with S. pneumoniae sepsis. This retrospective study enrolled children with S. pneumoniae sepsis who presented to the Children's Hospital of Chongqing Medical University from May 2011 to December 2018. Classification and regression tree (CART) analysis was used to determine the time to appropriate t...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
Multidrug-resistant gram-negative bacilli (MDR-GNB) have emerged globally as a serious threat and with a high case fatality rate (CFR). Neonates suspected of sepsis with septic shock need broad-spectrum empirical antimicrobial therapy until the second successive negative culture, especially in high MDR areas.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
AbstractEarly appropriate antimicrobial therapy is crucial in patients with sepsis and septic shock. Studies often focus on time to first dose of appropriate antibiotics, but subsequent dosing is equally important. Our aim was to investigate the impact of fulfillment of early treatment, with focus on appropriate administration of first and second doses of antibiotics, on 28-day mortality in patients with community-onset severe sepsis and septic shock. A retrospective study on adult patients admitted to the emergency department with community-onset sepsis and septic shock was conducted 2012 –2013. The criterion &ldquo...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
Contributors : Anna Coulibaly ; Holger A LindnerSeries Type : Expression profiling by arrayOrganism : Homo sapiensTimely and reliable distinction of non-infectious systemic inflammatory response syndrome (SIRS), common in critically ill patients, from sepsis to support adequate antimicrobial therapy safes lives but is clinically challenging. Expeditious sepsis biomarkers are thus urgently sought. Blood transcriptional profiling provides insights into sepsis pathophysiology, but variability in leukocyte subtype composition complicates profile interpretation, and reliable reference genes to normalize gene expression in sepsi...
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Expression profiling by array Homo sapiens Source Type: research
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