Document Detail

Evidence-based sepsis therapy: a hospitalist perspective.
MedLine Citation:
PMID:  17219514     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Severe sepsis and septic shock are common and associated with a 30-50% mortality rate. Evidence-based therapies for severe sepsis supported by international critical care and infectious disease societies exist, but are inconsistently employed. METHODS: The epidemiology and definitions of sepsis syndromes are reviewed; sepsis therapies supported by definitive studies in the field, along with the supporting literature, are summarized and presented from a hospitalist perspective. CONCLUSIONS: Compelling observational data supports the importance of early, effective antibiotics. Well-designed randomized controlled trials and/or meta-analyses demonstrate the impact of activated protein C, early goal-directed therapy, stress-dose steroids, and intensive insulin in well-defined subgroups of patients. These therapies reduce the absolute mortality risk associated with severe sepsis by 9.5-16%; the corresponding numbers needed to treat to save one life are 6.25-10.5. While major trials are ongoing and the evidence for several sepsis therapies are limited to single trials, the available evidence indicates that appropriate use of these treatments can substantially reduce mortality from severe sepsis.
Ian Jenkins
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of hospital medicine : an official publication of the Society of Hospital Medicine     Volume:  1     ISSN:  1553-5606     ISO Abbreviation:  J Hosp Med     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2007-01-12     Completed Date:  2007-03-22     Revised Date:  2010-06-30    
Medline Journal Info:
Nlm Unique ID:  101271025     Medline TA:  J Hosp Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  285-95     Citation Subset:  IM    
University of California, San Diego, Department of Medicine, San Diego, California, USA.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Evidence-Based Medicine / methods*
Hospitalists / methods*
Sepsis / epidemiology,  mortality,  therapy*
Reg. No./Substance:
0/Anti-Bacterial Agents
Comment In:
J Hosp Med. 2007 Mar;2(2):117; author reply 118   [PMID:  17427979 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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