Journal
CURRENT INFECTIOUS DISEASE REPORTS
Volume 17, Issue 7, Pages -Publisher
SPRINGER
DOI: 10.1007/s11908-015-0493-6
Keywords
Septic shock; Sepsis; Infection; Antimicrobial; Antibiotic; Pharmacokinetics; Combination therapy; Survival
Categories
Funding
- KM1 Comparative Effectiveness Research Career Development Award [KM1CA156708-01]
- Clinical and Translational Science Award (CTSA) program of the National Center for Advancing Translational Sciences (NCATS) [UL1RR024992]
- Barnes-Jewish Patient Safety and Quality Career Development Program
- Foundation for Barnes-Jewish Hospital
- Astellas
- Pfizer
- GSK
- Roche
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Mortality and morbidity in severe sepsis and septic shock remain high despite significant advances in critical care. Efforts to improve outcome in septic conditions have focused on targeted, quantitative resuscitation strategies utilizing intravenous fluids, vasopressors, inotropes, and blood transfusions to correct disease-associated circulatory dysfunction driven by immune-mediated systemic inflammation. This review explores an alternate paradigm of septic shock in which microbial burden is identified as the key driver of mortality and progression to irreversible shock. We propose that clinical outcomes in severe sepsis and septic shock hinge upon the optimized selection, dosing, and delivery of highly potent antimicrobial therapy.
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