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Antibiotic management of sepsis: current concepts.

BACKGROUND
The development of guidelines for sepsis management has improved disease survival and reduced treatment costs. Adequate antibiotic therapy is the cornerstone of sepsis treatment. Specific rules should be established in every institution according to its profiles.


OBJECTIVES
To review the current knowledge about the best drugs to be used as empiric treatment for sepsis based on their clinical efficacy and costs.


METHODS
Medline 1950 - 2008 was searched using the following terms: sepsis, organ failure, system failure, SIRS, septic shock, antibiotic, pneumonia, urinary tract infection, urosepsis, catheter-related infection, bloodstream, abdominal infection, and surgical wound.


RESULTS/CONCLUSION
For most septic shock patients, monotherapy is adequate and treatment should be initiated in the first hour after first sepsis-induced organ dysfunction. The drug of choice varies in different situations and choosing the right antibiotic enables better survival, fewer complications and shorter stays in intensive care.