Hello All,
We are seeing resistance to giving antibiotics early in patients who meet
criteria for severe sepsis but do not have a source. The argument often goes
like this: "The patient is not critically ill and I do not have a source.
Antibiotics will cloud an unclear picture further and have side effects such as
liver and renal failure and breed resistance. I am going to hold off on
antibiotics unless a source becomes apparent." Often, but not always, these
patients will get their positive urine or blood culture 2-3 days later and we
will have been out of compliance and put the patient at risk. Antibiotics
noncompliance in nonshock septic patients is our most common miss in the
bundles.
I would appreciate help in formulating counterarguments to these concerns.
Especially useful would be articles demonstrating the safety of single doses of
antibiotics and the consequences of incorrect antibiotics in sepsis and severe
sepsis (Not Septic Shock which Dr. Kumar and others have addressed nicely).
Thanks,
RIck RutherfordSepsis Task Force ChairVentura County Medical Center
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