How is multiple organ dysfunction syndrome (MODS) in sepsis prevented?

Updated: Jan 27, 2020
  • Author: Ali H Al-Khafaji, MD, MPH, FACP, FCCP, FCCM; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Patients with impaired host defense mechanisms are at greatly increased risk for sepsis and MODS. The main causes are chemotherapeutic drugs, malignancy, severe trauma, burns, diabetes mellitus, renal or hepatic failure, old age, ventilatory support, and invasive catheters.

One way of helping to prevent severe sepsis is to avoid invasive catheters or remove them as soon as possible. Prophylactic antibiotics in the perioperative phase, particularly after gastrointestinal surgery, may be beneficial. Use of topical antibiotics around invasive catheters and as part of a dressing for patients with burns is helpful. Maintenance of adequate nutrition, administration of pneumococcal vaccine to patients who have undergone splenectomy, and early enteral feeding are other preventive measures.

Topical or systemic antibiotics have been given to prevent sepsis and MODS in high-risk patients. The use of nonabsorbable antibiotics in the stomach to prevent translocation of bacteria and occurrence of bacteremia has been a controversial issue. Numerous trials have been performed over the years using either topical antibiotics alone or a combination of topical and systemic antibiotics.

A systematic review by Nathens presented no benefit in medical patients but a reduced mortality in surgical trauma patients. [29] The beneficial effect was from a combination of systemic and topical antibiotics, predominantly involving reduction of lower respiratory tract infections in patients who were treated.


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