Therapy: the clinician's view

Abstract

The therapy of septicaemia often has to be started empirically and the clinician's choice of antibiotic depends upon awareness of data collected by the microbiologist concerning the species and sensitivity of the likely infecting bacteria. There is, however, no unequivocally correct choice and host factors, previous antibiotic use and local formulary recommendations need to be considered. The role of new antibiotics, the potential for cidal agents to be detrimental, the use of antibiotic combinations, the dose and duration of therapy are also still debatable. Even with optimal antibiotic therapy, some patients with septicaemia still die. Several forms of adjunctive therapy have been shown to be unhelpful but developments in immunotherapy hold out some promise.