In previous pearls, we have discussed the importance of early antimicrobial administration for patients with sepsis.
In patients with septic shock, current guidelines recommend empiric antimicrobial therapy be initiated within 1 hour.
Equally as important as early administration is the selection of appropriate antimicrobial therapy (i.e. choosing an antibiotic that is effective against the presumed or identified pathogen).
In one of the most recent studies, investigators found a 5-fold reduction in survival (52% vs. 10.3%) between patients who received appropriate antibiotics compared to those who received antibiotics that were ineffective against the identified pathogen.
In fact, choosing the right antibiotic is one of the strongest factors associated with patient outcome in sepsis.
When selecting empiric antimicrobial therapy for patients with septic shock consider patient history, co-morbidities, the clinical site of infection, and local resistance data.
References
Kumar A, Ellis P, Arabi Y, et al. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest 2009; 136:1237-48.
