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Killer antibiotic stewardship strategy? (The ADAPT-Sepsis trial)

First 10 EM

Optimizing sepsis care, including the appropriate length of antibiotic therapy, is an important goal. So should we be willing to allow an increase in mortality to reduce total antibiotic use, as the ADAPT-Sepsis non-inferiority design seems to imply? The ADAPT-Sepsis trial) appeared first on First10EM.

Sepsis 101
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"Sepsis bundles": No good evidence of benefit

PulmCCM

SEP-1, the Centers for Medicare & Medicaid Services (CMS)’s much-maligned sepsis “quality” measure, was the brainchild of a small group of insiders conceived in the early- to mid-2000s. SEP-1 was pushed through without waiting for the outcomes of three ongoing multicenter trials testing goal-directed therapy for sepsis.

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Insiders

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A New Tool to Help Screen for Sepsis in Kids?

Taming the SRU

Ann Emerg Med 2024; Big Picture Current screening tools for pediatric septic shock and sepsis are highly specific but lack sensitivity. This study substituted age adjusted vital sign measures and a pediatric shock index into currently existing pediatric sepsis scoring systems to create the qPS4.When TamingtheSRU. 10/31/24.

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ADAPT-Sepsis

Critical Care North Hampton

Discover how the ADAPT-Sepsis trial showed a PCT-guided approach can safely reduce antibiotic duration in critically ill sepsis patients.

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Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis?

RebelEM

Bottom Line Up Top: There doesnt appear to be a morbidity or mortality benefit to treating fever in sepsis and fever may have a protective effect. A large observational study of > 2000 patients found an association with fever at presentation and ICU survival for patients with severe sepsis or septic shock ( Sunden-Culberg 2017 ).

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SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis

The Skeptics' Guide to EM

Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis. Background: Rapid and accurate diagnosis of sepsis is critical, as early intervention can significantly reduce patient mortality. Reference: Agnello et al. His WBC is elevated at 23,000 with a left shift.

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Pre-Hospital Antibiotics in Sepsis?

RebelEM

Background: Sepsis remains one of the leading causes of morbidity and mortality. Prehospital Administration of Broad-Spectrum Antibiotics for Sepsis Patients: A Systematic Review and Meta-Analysis. It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Health Sci Rep 2022.

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