Culture Negative Severe Sepsis

Shipra Gupta, Ankit Sakhuja Gagan Kumar et el published a retrospective study of culture negative sepsis in December, 2016  issue of Chest.   PATIENT POPULATION Nationwide Inpatient Sample (NIS) database (USA) from 2000 to 2010, total of 6,843,279 admissions of patients with severe sepsis were studied, 3,226,406 (47.1%) had culture-negative results.   WHAT DID THEY … Read more

New Surviving Sepsis Guidelines

New surviving sepsis guidelines were just been released, incorporating new evidence and new sepsis definition. It is a 38 page document(excluding references) . Here is a concise summary of the new guidelines.   FOR RECOMMENDATIONS Treatment and resuscitation should begin immediately. 30 mL/kg of IV crystalloid fluid should be given within the first 3 hours. … Read more

Poor adherence to CLABSI prevention guidelines worldwide

Cristina Valencia, Naïma Hammami et el published a worldwide survey of healthcare professionals in this month’s Antimicrobial Resistance & Infection Control journal. Overall, only 23% of the ICUs strictly adhere to the guidelines to prevent CLABSI. Just for review, here are the components of CLABSI prevention bundle by the Joint Commission  Hand hygiene Hands are … Read more

Adjunctive early hydrocortisone therapy does not prevent the development of septic shock in patients with severe sepsis

The Hydrocortisone  for Prevention of Septic Shock (HYPRESS) study was published in JAMA on Oct 3, 2016. 380 patients with sepsis (with evidence of infection plus at least 2 systemic inflammatory response syndrome criteria and evidence of organ dysfunction ) were  randomized either to receive a continuous infusion of 200 mg of hydrocortisone for 5 days or placebo. There … Read more

Journal club : Empiricus trial

Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonization, and Multiple Organ Failure The EMPIRICUS Randomized Clinical a multicenter, randomized, double-blind, and parallel-group study Background Few randomized trials compared antifungals (fluconazole and capsofungin) to placebo empirically in critically ill septic patients. They failed to provide any benefit, however, empirical antifungal therapy is recommended … Read more

Remdesivir, Hydroxychloroquine, Lopinavir/Ritonavir and Interferon, all fail in Solidarity trial.Read more