期刊论文详细信息
Critical Care
Initial antimicrobial management of sepsis
Lila Bouadma1  Jan DeWaele2  Nick Daneman3  Marin H. Kollef4  Rebecca M. Baron5  Thierry Calandra6  Girish B. Nair7  Michael S. Niederman8  Jeffrey Lipman9 
[1] AP-HP, Bichat Claude Bernard, Medical and Infectious Diseas ICU, University of Paris, Paris, France;Department of Critical Care Medicine, Surgical Intensive Care Unit, Ghent University, Ghent, Belgium;Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada;Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA;Harvard Medical School; Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, 02115, Boston, MA, USA;Infectious Diseases Service, Department of Medicine, Lusanne University Hospital, University of Lusanne, Lusanne, Switzerland;Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA;Pulmonary and Critical Care Medicine, New York Presbyterian/Weill Cornell Medical Center, 425 East 61st St, 10065, New York, NY, USA;Royal Brisbane and Women’s Hospital and Jamieson Trauma Institute, The University of Queensland, Brisbane, Australia;Nimes University Hospital, University of Montpelier, Nimes, France;
关键词: Sepsis;    Antibiotic therapy;    Antimicrobial therapy;    Fungal infection;    Pneumonia;    Intra-abdominal infection;    Pharmacokinetics;    Bacteremia;    Biomarkers;   
DOI  :  10.1186/s13054-021-03736-w
来源: Springer
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【 摘 要 】

Sepsis is a common consequence of infection, associated with a mortality rate > 25%. Although community-acquired sepsis is more common, hospital-acquired infection is more lethal. The most common site of infection is the lung, followed by abdominal infection, catheter-associated blood steam infection and urinary tract infection. Gram-negative sepsis is more common than gram-positive infection, but sepsis can also be due to fungal and viral pathogens. To reduce mortality, it is necessary to give immediate, empiric, broad-spectrum therapy to those with severe sepsis and/or shock, but this approach can drive antimicrobial overuse and resistance and should be accompanied by a commitment to de-escalation and antimicrobial stewardship. Biomarkers such a procalcitonin can provide decision support for antibiotic use, and may identify patients with a low likelihood of infection, and in some settings, can guide duration of antibiotic therapy. Sepsis can involve drug-resistant pathogens, and this often necessitates consideration of newer antimicrobial agents.

【 授权许可】

CC BY   

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