Sepsis diagnosis challenge leads to overuse of antibiotic

26 Mar 2019

Delays in recognising and treating sepsis contribute to worse outcomes for patients, yet recognising this overwhelming infection remains a challenge.

University of Queensland Child Health Research Centre Associate Professor Luregn Schlapbach said more research was needed to improve the timely recognition and treatment of sepsis, particularly in children.

"There is no question that the best approach for children suffering from bacterial sepsis or septic shock is to administer antibiotics quickly," Dr Schlapbach said.

"However, antibiotics are usually not required for milder infectious illnesses, such as flu.

"Efforts need to be focused on improving sepsis diagnosis – the challenge is to tell children with sepsis apart from children who are not suffering from it.

"As doctors, we need to become better at what we do and make sure every child with sepsis gets the appropriate attention and rapid treatment.

“A big challenge remains in the diagnosis of sepsis and bacterial infections.

“Once we know a patient has sepsis, the best choice of treatment - at present - is taking blood cultures and starting treatment with antibiotics and intravenous fluids.

“Many patients also require intensive care support.”

Initially, children may present to hospital with vague and non-specific symptoms which make it difficult for doctors to correctly diagnose the illness.

"Antibiotics save lives and are our strongest weapon against sepsis and other illnesses,” Dr Schlapbach said.

"While we are committed to improving care for children with sepsis, we must ensure antibiotics are not administered if they are not required.

"It’s a priority that we improve recognition of bacterial infections and give doctors the tools to become more effective in administering treatment to those who need it."

It’s hoped that future research and clinical trials would address these issues and enable advanced detection of bacterial infections and septic shock in children.

The opinion piece was led by Associate Professor Luregn Schlapbach in collaboration with Dr Scott L Weiss from the University of Pennsylvania School of Medicine and Pediatric Sepsis Program at the Children's Hospital of Philadelphia and Dr Joshua Wolf from the University of Tennessee Health Science Centre.

This article was published in Jama Pediatrics (DOI:10.1001/jamapediatrics.2019.0174).

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