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Content Update

August 16, 2023

Surviving Sepsis and Antimicrobial Stewardship in the Emergency Department: Sepsis and septic shock are medical emergencies associated with high morbidity and mortality. The Surviving Sepsis Campaign, which underwent a revision in October 2021, provides recommendations for the management of sepsis and septic shock. The updated guideline addresses key topics related to antimicrobial stewardship including initiation of antimicrobials, selection of antimicrobials based on patient specific risk factors, and duration of therapy. These points, which are further discussed throughout this update, are relevant to practice as they provide guidance on how to best manage septic patient whiles promoting antimicrobial stewardship and reducing the overuse of antimicrobials.

Content Update

March 15, 2023

Inpatient Management of COVID-19: The National Institutes of Health (NIH) frequently release COVID-19 guideline updates to assist with the diagnosis, treatment and management of patients infected with COIVD-19. The management of inpatients with COVID-19 varies greatly depending on patient risk factors, disease severity and medication availability. Pharmacologic treatment involves a variety of therapies that target different pathologic mechanisms including antivirals, anti-inflammatory agents, and immunomodulatory agents, This update will focus on new pharmacotherapy recommendations regarding the inpatient management of COVID-19.

Content Update

December 05, 2022

Management of Gram-Negative Bacteremia: Focus on duration of therapy Updated data and expert opinion suggest opportunities to optimize the management of uncomplicated gram-negative bacteremia (GNB). Specifically, emerging literature support short course (i.e., 7 days) therapy for GNB in select patients who have source control, achieve hemodynamic stability, and are afebrile without other signs of dissemination. Highlighted below is a focused update on literature supporting optimal antibiotic duration of therapy in GNB.

LEARNING OBJECTIVES

LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Compare and contrast the definitions of syndromes related to sepsis.

  2. Identify the pathogens associated with sepsis.

  3. Discuss the pathophysiology of sepsis as it relates to systemic inflammation, coagulation, and tissue hypoperfusion.

  4. Identify patient symptoms as early or late sepsis and evaluate diagnostic and laboratory tests for patient treatment and monitoring.

  5. Assess complications of sepsis syndromes and discuss their impact on patient outcomes.

  6. Design desired treatment outcomes for septic patients.

  7. Formulate a treatment and monitoring plan (pharmacologic and nonpharmacologic) for septic patients.

  8. Evaluate patient response and devise alternative treatment regimens for nonresponding septic patients.

INTRODUCTION

image Sepsis occurs across a continuum of physiologic stages in response to infection, which manifests as systemic inflammation, coagulation, and tissue hypoperfusion, potentially leading to organ dysfunction.1 The Third International Consensus Definitions for Sepsis and Septic Shock define sepsis as a life-threatening organ dysfunction caused by a dysregulated host response represented by an increase of at least 2 points in the Sequential (Sepsis-related) Organ Failure Assessment (SOFA) score (Table 84–1). Septic shock is defined as a ...

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