Antibiotics in sepsis

Division of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Intensive Care Medicine (Impact Factor: 7.21). 02/2001; 27 Suppl 1(14):S33-48. DOI: 10.1007/PL00003796
Source: PubMed
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Available from: Pierre-Yves Bochud,
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    • "They have to be used expeditiously along with other early interventions for sepsis. However, the use of antibiotics is known to trigger the release of bacterial cell wall components that contribute to the severe inflammation in the body that leads to sepsis [8]. First report: The spontaneous and penicillin-stimulated release of water-soluble, glycerol-labeled polymers was compared in Streptococcus sanguis. "
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    ABSTRACT: Sepsis, a serious cause of morbidity in humans, has no proper single medication dedicated to it. In this review, we look at the current treatment modalities, the different approaches attempted towards treating it and alternative approaches that could be implemented to counter this neglected disease condition. The use of antibiotics towards treatment of sepsis, use of combinations and strategies derived from natural antimicrobial peptides has been dealt with in details. The social and technical difficulties associated with treating sepsis and the possible ways of combating them have also been discussed. Copyright © 2015. Published by Elsevier Ltd.
    Microbial Pathogenesis 02/2015; 80. DOI:10.1016/j.micpath.2015.02.001 · 1.79 Impact Factor
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    • "Firstly, the method has a low sensitivity both to slow-growing and fastidious organisms [5] and when antibiotics have been given prior to culture [6,7]. Previous studies have shown that a positive BC is only found in about 30% of patients with severe sepsis and septic shock [8]. Secondly, it takes between 24 to 72 hours before the pathogen is identified. "
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    ABSTRACT: The commercial test, SeptiFast, is designed to detect DNA from bacterial and fungal pathogens in whole blood. The method has been found to be specific with a high rule-in value for the early detection of septic patients. In the case of positive results, the software automatically provides information about the identified pathogen, without quantification of the pathogen. However, it is possible to manually derive Crossing point (Cp) values, i.e. the PCR cycle at which DNA is significantly amplified. The aim of this study was to find out whether Cp values correlate to disease severity. We used a study cohort of patients with positive results from SeptiFast tests for bacteria (coagulase-negative staphylococci excluded) from a recent study which included patients with suspected sepsis in the Emergency department. Cp values were compared with disease severity, classified as severe sepsis/septic shock or non-severe sepsis, according to the criteria of the American College of Chest Physicians/Society of Critical Care Medicine. Ninety-four patients with a median age of 74 years (range 14-96 years) were included. The prevalence of severe sepsis/septic shock in the study was 29% (27/94). SeptiFast positive blood samples from patients with severe sepsis/septic shock had significantly lower Cp median values compared with those from patients with non-severe sepsis, i.e. 16.9 (range: 7.3 - 24.3) versus 20.9 (range: 8.5 - 25.0), p < 0.001. Positive predictive values from the SeptiFast test for identifying severe sepsis/septic shock were 34% at SeptiFast Cp cut-off <25.0, 35% at Cp cut-off <22.5, 50% at Cp cut-off <20.0, and 73% at Cp cut-off <17.5. Patients with a positive Septifast test with a Cp value <17.5 had significantly more severe sepsis (73% versus 15%, p < 0.001), developed more septic shock (14% versus 0%, p = 0.010), were more often admitted to the Intensive Care Unit (23% versus 4%, p = 0.016), had positive blood culture (BC) more frequently (100% versus 32%, p < 0.001) and had longer hospital stays (median 19.5 [range: 4-78] days versus 5 [range: 0-75] days, p < 0.001) compared with those with a Cp value >17.5. Our results suggest that introducing quantitative data to the SeptiFast test could be of value in assessing sepsis severity. Moreover, such data might also be useful in predicting a positive BC result.
    BMC Infectious Diseases 03/2014; 14(1):155. DOI:10.1186/1471-2334-14-155 · 2.61 Impact Factor
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    • "The therapeutic management of sepsis, including septic shock, requires a comprehensive and systematic approach that includes a diagnostic method, the initiation of empirical antibiotic use and administration of supportive therapy.[5] Empirical antibiotic use is needed to eradicate the microbe that causes sepsis. "
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    ABSTRACT: The appropriate selection of empirical antibiotics based on the pattern of local antibiotic resistance can reduce the mortality rate and increase the rational use of antibiotics. We analyze the pattern of antibiotic use and the sensitivity patterns of antibiotics to support the rational use of antibiotics in patients with sepsis. A retrospective observational study was conducted in adult sepsis patient at one of Indonesian hospital during January-December 2011. Data were collected from the hospital medical record department. Descriptive analysis was used in the processing and interpretation of data. A total of 76 patients were included as research subjects. Lung infection was the highest source of infection. In the 66.3% of clinical specimens that were culture positive for microbes, Klebsiella pneumoniae, Escherichia coli, Staphylococcus hominis were detected with the highest frequency. The six most frequently used antibiotics, levofloxacin, ceftazidime, ciprofloxacin, cefotaxime, ceftriaxone, and erythromycin, showed an average resistance above 50%. The high use of antibiotic with a high level resistance requires a policy to support its rational use. Local microbial pattern based on site infection and pattern of antibiotics sensitivity test can be used as supporting data to optimize appropriateness of empirical antibiotics therapy in sepsis patients.
    North American Journal of Medical Sciences 06/2013; 5(6):344-52. DOI:10.4103/1947-2714.114165
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