What are the considerations when using antimicrobial therapy in the treatment of sepsis/septic shock?

Updated: Oct 07, 2020
  • Author: Andre Kalil, MD, MPH; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

The following points must always be considered:

  • Early broad-spectrum empiric antibiotic therapy is essential; the coverage spectrum will be narrowed later, when culture results become available

  • Waiting until cultures are back is an invalid reason to withhold antibiotics

  • Only 30% of patients with presumed septic shock have positive blood cultures [3, 4, 5, 37]

  • About 25% of presumed septic shock patients remain culture-negative from all sites, but mortality is similar to that for culture-positive counterparts [3, 4, 5, 37]

  • Promptly discontinue antimicrobial therapy if the patient’s condition is determined to be from a noninfectious source [11, 60]


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