Modern Paradigms in Sepsis Management: A Journey from Recognition to Personalisation: A Narrative Review

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection and remains a major global health concern, particularly in intensive care settings. Despite advances in medical science, it continues to be one of the leading causes of mortality and long-term morbidity worldwide. The present review highlights recent advances in sepsis diagnosis and treatment, ranging from early detection strategies and personalised therapies to emerging therapeutic interventions. Early and accurate diagnosis is central to successful sepsis management. The introduction of advanced biomarkers such as Procalcitonin (PCT) and Interleukins (ILs), along with Artificial Intelligence (AI) and machine learning platforms, has significantly enhanced early recognition and risk stratification. Point-of-care testing and rapid diagnostic technologies now allow for prompt pathogen identification and antimicrobial resistance profiling, facilitating timely and targeted intervention. Haemodynamic monitoring has also evolved, with goal-directed fluid resuscitation and vasopressor therapy guided by dynamic physiological parameters. Novel vasopressors and adjunctive treatments are under investigation to optimise tissue perfusion while minimising organ injury. Antimicrobial stewardship has gained increasing importance, with emphasis on early pathogen detection, resistance characterisation, and individualised antibiotic dosing to curb the emergence of multidrug-resistant organisms. Immunomodulatory therapies, including corticosteroids, cytokine modulators, and emerging monoclonal antibodies, are being explored to restore immune balance. Extracorporeal organ support technologies have improved survival in refractory cases, while advances in managing sepsis-induced coagulopathy have strengthened supportive care strategies. Furthermore, genomic and proteomic tools are enabling personalised therapeutic approaches, revolutionising precision medicine in sepsis care. Nanotechnology also holds promise for developing novel diagnostic platforms and targeted drug delivery systems. Collectively, these innovations represent a paradigm shift toward timely, patientcentred, and precision-based sepsis management. Continued research and clinical implementation are essential to maximise their benefits and reduce the global burden of this complex syndrome. The present review uniquely integrates emerging precisionbased strategies, advanced diagnostics, AI-driven tools, and individualised therapies to demonstrate how novel technologies are reshaping sepsis diagnosis, treatment, and outcomes.