World Sepsis Day

World Sepsis Day is held on September 13th every year. World Sepsis Day is an initiative of the Global Sepsis Alliance.

Sepsis is a global health crisis.  It affects between 47 and 50 million people every year.  At least 11 million die – one death every 2.8 seconds.  Of all deaths worldwide, 20% are associated with sepsis.  Depending on country, mortality varies between 15% and more than 50 %.  Many surviving patients suffer from the consequences of sepsis for the rest of their lives.  (Global Sepsis Alliance)

What is sepsis?

Sepsis is a life-threatening reaction of the body to infection.  It occurs when the body’s immune response to an ongoing infection begins to damage its own tissue.  As the body’s natural infection-fighting abilities increases, releasing a burst of chemicals into the bloodstream, widespread inflammation can lead to a multitude of issues.  These can include tissue damage, multi-system organ failure and even death.

Sepsis most commonly occurs in patients who are already hospitalized, and can progress to septic shock.  Septic shock is characterized by a dramatic drop in blood pressure.  Vulnerable patient populations such as neonates, paediatrics and geriatrics are at even greater risk.

Treatment of sepsis

Sepsis is often treated with antibiotics.  However, this comes with a cautionary note.  Since sepsis is a fairly sudden and very serious condition, attempts to prevent the patient’s condition from worsening can contribute to the widespread problem of antibiotic overuse.

According to the World Health Organization (WHO), antibiotic resistance is rising to dangerously high levels in all parts of the world as new resistance mechanisms are emerging and spreading globally.  With antibiotics becoming less effective, it has grown increasingly difficult, and in some cases impossible, to treat patients for even common infectious diseases like pneumonia.

Patient care is also becoming more costly as first-line antibiotics are being replaced by more expensive medications.  A longer duration of illness and treatment, often in hospitals, increases healthcare costs as well as the economic burden on patients and societies.

Balancing the urgency of prescribing antibiotics with the problem of antibiotic overuse

Septic patients present a challenge for healthcare practitioners, as there is the need to balance the urgency of prescribing antibiotics with the imperative to avoid imprudent antibiotic use.

Procalcitonin (PCT) is a biomarker used to predict the likelihood of a patient having a bacterial infection.  It also provides an indication of how severe that infection might be.  This offers healthcare practitioners a way to manage antibiotic exposure while also improving patient outcomes.

In various studies, PCT-guided antibiotic therapy has been shown to decrease the duration of antibiotic treatment for sepsis, decrease antibiotic costs and decrease the annual ICU re-infection rate.  Healthcare practitioners can use serial PCT measurements, taken over consecutive days, to help them assess the response to antibiotic therapy and the risk of all-cause mortality among ICU patients.  When the infection is controlled, PCT will rapidly decline daily.  If the PCT level has not significantly declined, the patient and antibiotic therapeutic approach should be reassessed.