A systematic review on de-escalation of antibiotics uses in surgical patients in clinical sepsis

Abstract

Antimicrobial resistance is a feature of the current topography of clinical sepsis, and in the future, fewer and fewer new antibiotics, especially those from novel classes1, will be developed to address these problems. Effective antimicrobial treatment is necessary to ensuring good patient outcomes. Increased duration of stay, multidrug-resistant infections, and death can result from improper or inefficient use of antibiotics. Patients in intensive care who are critically sick are at risk for antibiotic failure and secondary infections brought on by improper antibiotic usage, especially those with severe sepsis and septic shock. Providers can speed up the treatment of common intensive care unit (ICU) infections by starting active empiric antibiotic therapy based on local susceptibilities, daily review of infection signs and symptoms, and, where practical, restricting antibiotic therapy. Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat. Early detection of septic patients enables the use of evidence-based therapies, including goal-directed resuscitation, rapid antibiotic administration, and activated protein C. It may be simpler to provide appropriate care for sepsis if this clinical entity is divided into several phases and new delivery structures that span traditional boundaries are implemented. More specialized treatments will be possible with a better understanding of the molecular underpinnings of the illness process.