Sepsis bundles as a standardized safety floor: toward adaptive precision care

This Commentary argues that sepsis bundles should serve as a standardized safety floor for time-critical care rather than a complete treatment prescription. The 2026 Surviving Sepsis Campaign guidelines retain rapid recognition, timely antimicrobial therapy, source-control assessment, initial hemodynamic stabilization, and basic organ support as key priorities [ 1 ]. These measures should not be delayed. However, even after initial bundle completion, patients may differ markedly in infection characteristics, vascular tone, cardiac function, fluid tolerance, immune status, and organ dysfunction. Bundle completion should therefore lead to adaptive reassessment rather than mark the end of treatment.