Septicaemia – Related resources

Cochrane reviews

• Polychlonal intravenous immunoglobulin seems to reduce mortality in sepsis, but monochlonal antibodies may not be effective, although the evidence is insufficient.
• Low dose of corticosteroids for five days is effective in improving survival in septic shock without causing harm .
• Adding an aminoglycoside to beta-lactams in the treatment of sepsis does not improve clinical efficacy achieved with the beta-lactam alone. Combination treatment carries a significant risk of nephrotoxicity .
• Activated protein C (APC) is not effective in reducing mortality in patients with sepsis.
• Hydroxyethyl starch colloids for fluid resuscitation in septic patients appear to decrease kidney function compared to other fluid therapy .
• Naloxone may be beneficial in septic shock, but the number of patients studied is small and there is a possibility of publication bias .

Other evidence summaries

• The diagnostic accuracy of PCT seems to be higher than that of CRP to differentiate bacterial infections from viral infections and other non-infective causes of systemic inflammation in hospitalized patients .
• Procalcitonin (PCT) test may have a low diagnostic performance in differentiating sepsis from systemic inflammatory response syndrome (SIRS) in critically ill adult patients .

Clinical guidelines

• Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock .
• Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock (2016)

Literature

Clinical practice reviews

• Peleg AY, Hooper DC. Hospital-acquired infections due to gram-negative bacteria. N Engl J Med 2010 May 13;362(19):1804-13.
• Mackenzie I, Lever A. Management of sepsis. BMJ 2007 Nov 3;335(7626):929-32.
• Lever A, Mackenzie I. Sepsis: definition, epidemiology, and diagnosis. BMJ 2007 Oct 27;335(7625):879-83.
• Playford EG, Eggimann P, Calandra T. Antifungals in the ICU. Curr Opin Infect Dis 2008 Dec;21(6):610-9.
• Greenwood BM. Corticosteroids for acute bacterial meningitis. N Engl J Med 2007 Dec 13;357(24):2507-9.

Systematic reviews and meta-analyses

• Gafter-Gvili A, Vidal L, Goldberg E, Leibovici L, Paul M. Treatment of invasive candidal infections: systematic review and meta-analysis. Mayo Clin Proc 2008 Sep;83(9):1011-21.
• Tang BM, Eslick GD, Craig JC, McLean AS. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis. Lancet Infect Dis 2007 Mar;7(3):210-7.
• Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis 2004 Jul 15;39(2):206-17.

Other literature

• Sprung CL, Annane D, Keh D et al; CORTICUS Study Group. Hydrocortisone therapy for patients with septic shock. N Engl J Med 2008;358(2):111-24.
• Karlsson S, Varpula M, Ruokonen E, Pettilä V, Parviainen I, Ala-Kokko TI, Kolho E, Rintala EM. Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study. Intensive Care Med 2007 Mar;33(3):435-43.