Bacterial Etiology and Antibiotic Management of Sepsis

INTRODUCTION: Sepsis is a medical emergency and life-threatening condition associated with high mortality. Initiating antibiotic therapy is crucial in confirmed cases of sepsis. Antimicrobial stewardship (AS) frameworks, guidelines approaches help us improve patient's quality of care.(1–4) OBJECTIVES: To understand the prevalence of common bacterial species and the use of antibiotics in the management of bacterial sepsis. MATERIALS AND METHODS: Nationwide structured survey was conducted among 301 Doctors, through an online platform (Insight – Imagica Health) to understand the bacterial etiology and antibiotic management of sepsis. RESULTS: In this nationwide structured survey, 301 Doctors were enrolled, through an online platform (Insight – Imagica Health). As per the survey report, the prevalence of sepsis in ICU-admitted patients is 40–50%. Pseudomonas aeruginosa is a common isolate prevalent in patients with sepsis followed by Klebsiella pneumoniae, Acinetobacter baummanni, and E. Coli. Doctors reported a prevalence of 21–30% for ESBL infections and 11–20% for Carbapenem-resistant Enterobacteriaceae (CRE) in their hospitals. Doctors emphasize the importance of early initiation of appropriate antimicrobial therapy and effective source control to improve survival rates. As reported by nearly 50% of the physicians (Fig. 1), Meropenem is considered as a preferred choice in Sepsis management, followed by Piperacillin-Tazobactum. The average duration of antibiotic therapy in sepsis is 5–7 days (Fig. 2), as reported by nearly 50% of the physicians. Moreover, around 90% of physicians deem de- escalation of empiric antibiotics necessary in sepsis to lower the emergence of drug resistance. CONCLUSIONS: Survey findings suggest that Pseudomonas aeruginosa is a common isolate prevalent in patients with sepsis followed by Klebsiella pneumoniae, Acinetobacter baumannii, and E. Coli with presence of ESBL and CRE infections. Survey findings emphasize the importance of early initiation of appropriate antimicrobial therapy to improve survival rates. Average duration of antibiotic therapy in sepsis is 5–7 days as reported by major enrolled population. Meropenem is considered as a preferred choice in sepsis management. De-escalation of empiric antibiotics is necessary to lower the emergence of drug resistance.