Updated guidelines for sepsis management

Author(s): Lydia L. Kim, Digital Content Editor

A new study from the University of Arizona Health Sciences reveal updates to sepsis management.

Sepsis, a life-threatening infection that can cause the immune system to attack the body, has a mortality rate of 20%. Each year approximately 1.7 million adults in the United States develop sepsis.

Historically, sepsis management focused on antibiotics, but there has been debate around this treatment paradigm. Some physicians feel they should draw two blood cultures before beginning treatment, while others feel that this could result in significant treatment delays, ultimately decreasing the patient’s chances for survival.

Murtaza Akhter, MD, an assistant professor at the University of Arizona Health Sciences and co-author of the study, speaks to this concern: “This is a constant debate in the medical field…Emergency medicine physicians want to administer antibiotics as soon as possible because it prevents mortality, whereas internal medicine physicians want two sets of blood cultures before antibiotics are administered so they can more reliably diagnose the organism…Although administering antibiotics to septic patients is important, it is imperative to get at least one blood culture before providing the treatment.”

The study in question measured “the reliability of administering antibiotics before obtaining blood cultures.” The study revealed that if antibiotics were administered immediately, they reduces the “sensitivity of blood cultures,” which in turn, “reduces the chances of treating and tailoring antibiotics to specific bacterial and fungal sepsis infection.”

Before this study, it was unknown how quickly antibiotic sensitivity changed; some thought if the drugs were administered prior to the blood cultures, they would still be able to properly diagnosis. This new study has shown that “this strategy fails” due to how quickly the cultures are affected by the administration of antibiotics.

Dr. Akhter summarizes the study: “We already knew that emergency physicians were correct to not delay antibiotics, but now we know that internal medicine doctors were also correct in that blood cultures after antibiotics are not as reliable.”

Please find the entire study here.

References:

https://opa.uahs.arizona.edu/newsroom/news/2019/study-changes-guidelines-sepsis-management

 

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