Appropriate initial antimicrobial therapy reduces mortality in patients with septic shock

Patients experiencing septic shock who receive inappropriate therapy may have a fivefold reduction in survival, shows a new study. Researchers from the University of Manitoba, Winnipeg, MB, Canada, retrospectively reviewed the cases of 5,715 patients with septic shock to determine the appropriateness of initial antimicrobial therapy, clinical infection site, and relevant pathogens.

Results showed that inappropriate initial antimicrobial therapy occurred in 20 percent of patients, and the overall survival was 43.7 percent. Survival after appropriate and inappropriate initial therapy was 52 percent and 10.3 percent, respectively.

Furthermore, the decrease in survival with inappropriate initial therapy ranged from 2.3-fold for pneumococcal infection to 17.6-fold with primary bacteremia. Researchers conclude that efforts to increase the frequency of appropriateness of initial antimicrobial therapy must be central to efforts to reduce mortality from septic shock.

The article is published in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.