Author/Editor		Beović, Bojana; Reberšek-Gorišek, Jelka
Title		Izkustveno antibiotično zdravljenje sepse pri odraslem
Translated title		Empirical antibiotic treatment of sepsis in adults
Type		članek
Source		In: Baklan Z, Reberšek-Gorišek J, Kotnik-Kervokljan B, editors. Zbornik predavanj in praktikum Bedjaničev simpozij z mednarodno udeležbo o temi Sepsa in septični šok; 2003 maj 31-31; Maribor. Maribor: Splošna bolnišnica Maribor,
Publication year		2003
Volume		str. 131-42
Language		slo
Abstract		The incidence of sepsis is increasing as a consequence of aging of the population in fhe developed world and invasive treatment methods of modern medicine. Staphylococci and Enterobacteriaceae are most common causative microorganisms of sepsis, accompanied by pneumococci in community acquired cases. Urinary tract is a frequent primary site of infection in patients with sepsis in general, pneumonia is a common source af severe sepsis. Initial antimicrobial treatment of sepsis is empirical in most cases. Several studies have demonstrated the correlation between inapropriate initial empirical treatment of sepsis and sepsis mortality: Appropriate antimicrobial treatment is difficult to achieve in the environement with high prevalence of resistant bacteria. Broad spectrum antimicrobial treatment used for empirical therapy worsens the antibiotic susceptibility of bacteria further. The vitious circle may be overcome by prudent use of antibiotics. Several studies showed the same efficacy of carbapenems and third to fourth generation cephalosporins as monotherapy compared with combinations of betalactams and aminoglycosides. Aminoglycosides are still recommended in some guidelines to broaden the antimicrobial spectrum of the empirical therapy and to achieve antimicrobial synergy. Guidelines for the empirical antimicrobial treatment of sepsis should reflect local data on the causative microorganisms and their susceptibility to antibiotics. The guidelines should improve the quality of care of an individual patient taking into account the impact of the antimicrobial therapy on the antibiotic resistance and the treatment cost.
Descriptors		SEPSIS ANTIBIOTICS CEPHALOSPORINS CARBAPENEMS VANCOMYCIN GENTAMICINS