Antibiotic therapy in sepsis: No next time for a second chance!

Abstract

What is known and objective Sepsis is a life‐threatening organ dysfunction associated with a high rate of morbidity and mortality. Appropriate antibiotic therapy remains the cornerstone of sepsis and septic shock management. Comment Although the early initiation of antimicrobial agents in the treatment of sepsis is widely acknowledged, the selection and adjustment to optimal dosage can be equally important. Since significant pathophysiological changes in the critically ill patients lead to altered pharmacokinetics of antibiotics, early consideration of pharmacokinetic/pharmacodynamic (PK/PD) properties is necessary for optimal antibiotic dosing in sepsis and should be integrated in practice. What is new and conclusion Where possible, an individualized antibiotic dosing approach through the application of therapeutic drug monitoring (TDM) service should replace the conventional dosing in critically ill patients with sepsis. Finally, antimicrobial stewardship can help improve clinical outcomes.

Long noncoding RNA MALAT1 inhibition attenuates sepsis‐induced acute lung injury through modulating the miR‐129‐5p/PAX6/ZEB2 axis

“…Sepsis is a complicated organ dysfunction accompanied by high morbidity and mortality 1 . This disease is a life‐threatening pathophysiological condition involving a series of organ dysfunction syndromes and tissue injuries such as acute lung injury (ALI) 2 .…”

“…Sepsis is a complicated organ dysfunction accompanied by high morbidity and mortality. 1 This disease is a lifethreatening pathophysiological condition involving a series of organ dysfunction syndromes and tissue injuries such as acute lung injury (ALI). 2 Sepsisinduced ALI, one of the common clinical syndromes, is characterized by alveolar epithelium and pulmonary endothelial cell injury.…”

Management of a critically ill patient with COVID-19-related fulminant myocarditis: A case report

“…Moreover, intravenous Ascorbic acid (Vitamin C) 1 g four times daily, and oral Melatonin 18 mg daily were prescribed for their antioxidant and anti‐inflammatory properties [ 6 , 7 ]. The patient received broad-spectrum antibiotics with individual doses as a part of the septic shock management [ 8 ]. On day 25, echocardiographic measurement was performed and LVEF was reported as 25%, accompanying PAP of 38 mmHg and moderate LV dysfunction and right ventricular (RV) dilation.…”

Recent Advances in Monoclonal Antibody-Based Approaches in the Management of Bacterial Sepsis

“…Early diagnosis followed by immediate treatment entails the success rate of treatment in sepsis [ 7 ]. Currently, treatment for sepsis and septic shock deeply relies on fluid resuscitation and other general supportive measures along with broad-spectrum antibiotics administration [ 8 ].…”