Antimicrobial Step-Down Therapy versus Conventional Antimicrobial Therapy in the Treatment of Patients with Sepsis

Peng, Zhuo; Niu, Zequn; Zhang, Rui; Pan, Longfei; Feng, Hui; Zhou, Yang; Pei, Honghong

doi:10.1155/2022/3117805

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…The early use of antimicrobials can improve the prognosis of patients with sepsis, which is why international guidelines recommend the empirical use of broad-spectrum antibiotics, although they warn against their excessive use, which is commonly associated with the development of bacterial resistance ( 20 ) . Therefore, the Latin American recommendation emphasizes that combined therapy should be reserved for situations in which data from the local microbiota or the clinical situation suggest a greater probability of infection by resistant germs ( 21 ) .…”

Section: Discussionmentioning

confidence: 99%

Risk classification and door-to-antibiotic time in patients with suspected sepsis

Lima,

Nangino,

Soares

et al. 2023

Rev. Latino-Am. Enfermagem

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Objective: to evaluate the association between risk classification and door-to-antibiotic time in patients with suspected sepsis. Method: retrospective cohort study, with a sample of 232 patients with suspected sepsis treated at the emergency department. They were divided into 2 groups: with and without risk classification. Once the door-to-antibiotic time was identified, one-way analysis of variance was performed with Bonferroni post hoc test or independent Student’s t-test for continuous quantitative variables; Pearson correlation tests, point-biserial correlation or biserial correlation for association analyses; and bootstrap procedure when there was no normal distribution of variables. For data analysis, the Statistical Package for the Social Sciences software was used. Results: the door-to-antibiotic time did not differ between the group that received risk classification compared to the one that was not classified. Door-to-antibiotic time was significantly shorter in the group that received a high priority risk classification. Conclusion: there was no association between door-to-antibiotic time and whether or not the risk classification was performed, nor with hospitalization in infirmaries and intensive care units, or with the length of hospital stay. It was observed that the higher the priority, the shorter the door-to-antibiotic time.

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Section: Discussionmentioning

confidence: 99%

Risk classification and door-to-antibiotic time in patients with suspected sepsis

Lima,

Nangino,

Soares

et al. 2023

Rev. Latino-Am. Enfermagem

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“…El uso temprano de antimicrobianos puede mejorar el pronóstico de los pacientes con sepsis, por lo que guías internacionales recomiendan el uso empírico de antibióticos de amplio espectro, aunque advierten contra su utilización excesiva, que comúnmente se asocia con el desarrollo de resistencia bacteriana (20) . Por tanto, la recomendación latinoamericana destaca que la terapia combinada debe reservarse para situaciones en las que datos de la microbiota local o de la situación clínica sugieran una mayor probabilidad de infección por gérmenes resistentes (21) .…”

Section: Discussionunclassified

Clasificación de riesgo y tiempo puerta-antibiótico en pacientes con sospecha de sepsis

Lima,

Nangino,

Soares

et al. 2023

Rev. Latino-Am. Enfermagem

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Objetivo: evaluar la asociación entre la clasificación de riesgo y el tiempo puerta-antibiótico en pacientes con sospecha de sepsis. Método: estudio de cohorte retrospectivo, con una muestra de 232 pacientes con sospecha de sepsis atendidos en el departamento de emergencias. Se dividieron en 2 grupos: con y sin clasificación de riesgo. Una vez identificado el tiempo puerta-antibiótico, se realizó un análisis de varianza de un factor con la prueba post hoc de Bonferroni o la prueba t de Student independiente para variables cuantitativas continuas; pruebas de correlación de Pearson, correlación biserial puntual o correlación biserial para análisis de asociación; y procedimiento de bootstrap cuando no había distribución normal de variables. Para el análisis de los datos se utilizó el software Statistical Package for the Social Sciences. Resultados: el tiempo puerta-antibiótico no difirió entre el grupo que recibió clasificación de riesgo en comparación con el que no fue clasificado. El tiempo puerta-antibiótico fue significativamente más corto en el grupo que recibió una clasificación de riesgo de alta prioridad. Conclusión: no hubo asociación entre el tiempo puerta-antibiótico y si se realizó o no la clasificación de riesgo, ni con la hospitalización en enfermería y en unidad de cuidados intensivos, ni con la duración de la estancia hospitalaria. Se observó que cuanto mayor era la prioridad, más corto era el tiempo puerta-antibiótico.

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“… 3 The current conventional treatment measures for sepsis mainly include fluid resuscitation, antimicrobial, anticoagulation drug therapy, organ function support and so on. However, the protective effects on intestinal barrier function are not predicted, 4 so it is urgent to find a new approach that can effectively protect the intestinal barrier function of sepsis.…”

Section: Introductionmentioning

confidence: 99%

Nano Parthenolide Improves Intestinal Barrier Function of Sepsis by Inhibiting Apoptosis and ROS via 5-HTR2A

Guo¹,

She²,

Tan³

et al. 2023

IJN

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Background Intestinal barrier dysfunction is an important complication of sepsis, while the treatment is limited. Recently, parthenolide (PTL) has attracted much attention as a strategy of sepsis, but whether nano parthenolide (Nano PTL) is therapeutic in sepsis-induced intestinal barrier dysfunction is obscured. Methods In this study, cecal ligation and puncture (CLP)-induced sepsis rats and lipopolysaccharide (LPS)-stimulated intestinal epithelial cells (IECs) were used to investigate the effect of PTL on intestinal barrier dysfunction. Meanwhile, we synthesized Nano PTL and compared the protective effect of Nano PTL with ordinary PTL on intestinal barrier function in septic rats and IECs. Network pharmacology and serotonin 2A (5-HTR2A) inhibitor were used to explore the mechanism of PTL on the intestinal barrier function of sepsis. Results The encapsulation rate of Nano PTL was 95±1.5%, the drug loading rate was 11±0.5%, and the average uptake rate of intestinal epithelial cells was 94%. Ordinary PTL and Nano PTL improved the survival rate and survival time of septic rats, reduced the mean arterial pressure and the serum level of inflammatory cytokines, and protected the liver and kidney functions in vivo, and increased the value of transmembrane resistance (TEER) reduced the reactive oxygen species (ROS) and apoptosis in IECs in vitro through 5-HTR2A. Nano PTL had better effect than ordinary PTL. Conclusion Ordinary PTL and Nano PTL can protect the intestinal barrier function of septic rats by inhibiting apoptosis and ROS through up-regulating 5-HTR2A, Nano PTL is better than ordinary PTL.

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Antimicrobial Step-Down Therapy versus Conventional Antimicrobial Therapy in the Treatment of Patients with Sepsis

Cited by 4 publications

References 24 publications

Risk classification and door-to-antibiotic time in patients with suspected sepsis

Risk classification and door-to-antibiotic time in patients with suspected sepsis

Clasificación de riesgo y tiempo puerta-antibiótico en pacientes con sospecha de sepsis

Nano Parthenolide Improves Intestinal Barrier Function of Sepsis by Inhibiting Apoptosis and ROS via 5-HTR2A

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