Abstract
Sepsis is one of the oldest and most elusive syndromes in medicine. Every effort should be made to treat these patients with the best available evidence. As a milestone, empiric antimicrobial therapy is essential in order to reduce morbidity and mortality of septic patients. As a sticking point, the use of broad-spectrum antimicrobial agents may be associated with induction of resistance among common pathogens.
Highlights
Sepsis is one of the oldest and most elusive syndromes in medicine
Rationale for early antibiotic therapy Worldwide, the annual prevalence of sepsis is estimated at 19 million cases [1]
Puskarich and colleagues [11] reported results from a large prospective study of emergency department patients with septic shock, which failed to demonstrate an association between timing of antibiotic administration from emergency department triage and hospital mortality
Summary
Broad-spectrum antimicrobial therapy is necessary within the ‘golden hour’ in septic shock and, as a milestone, reduces mortality. The use of broad-spectrum antimicrobial agents may be associated with induction of resistance among common pathogens and may be a sticking point. New research is urgently needed concerning different strategies that would balance early administration of antibiotics against the potential harmful effects to patients and resistance. New research strategies have to test a de-escalating strategy with restriction of specific broad-spectrum antibiotics in the initial therapy to the most critically ill patients and patients with suspicion of multidrug-resistant pathogens, against an escalating strategy in less critically ill patients. Author details 1Emergency Department, University Hospital of Leipzig, Liebigstrasse 20, D-04103 Leipzig, Germany. Ferrer et al [10] Crit Care Med (2014) Puskarich et al [11] Crit Care Med (2011)
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