Abstract:
INTRODUCTION:International guidelines have recommended for many years to start antimicrobials as early as possible in sepsis and shock. This concept has been challenged by the controversial results of experimental studies and clinical cohorts and resulted in intense debate in the literature. This review aims to summarize the available knowledge on early antimicrobial therapy and to consider perspectives. AREAS COVERED:First, after a research using MEDLINE, we reviewed the studies that advocated the implementation of early antimicrobial therapy. We then discussed the drawbacks of these studies. Finally, we suggested possible explanations of the benefit and then absence of the prognostic impact of early antimicrobial therapy i.e. confounding factors, irreversibility of the inflammatory process, non-control of the source of the infection, pharmacodynamic considerations and the harmful effect of antimicrobial drugs. EXPERT OPINION:Sepsis is very heterogeneous. The first antimicrobial therapy should be personalized. The sickest patients should be given early antimicrobial therapy, whereas a 'watch and wait process' should be preferred for less severe patients, to allow confirmation of sepsis, identification of pathogens and administration of adequate antimicrobial therapy. We propose steps to personalize the first antimicrobial therapy. New early diagnostic tools will assist the physicians in the future.
journal_name
Expert Rev Anti Infect Therjournal_title
Expert review of anti-infective therapyauthors
Dupuis C,Timsit JFdoi
10.1080/14787210.2020.1810567subject
Has Abstractpub_date
2021-01-01 00:00:00pages
45-54issue
1eissn
1478-7210issn
1744-8336journal_volume
19pub_type
杂志文章abstract::Healthy children are high transmitters of influenza and can experience poor influenza outcomes. Many questions remain about the efficacy and impect of preventive measures because most existing studies report imprecise proxies of influenza incidence, do not follow subjects throughout the entire influenza season and acr...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.12.106
更新日期:2012-10-01 00:00:00
abstract::Linezolid is the first member of a new generation of antibiotics, the synthetic oxazolidinones, to become available, with a broad spectrum of in vitro activity against gram-positive organisms, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecalis and vancomycin-resistant E. ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.4.6.947
更新日期:2006-12-01 00:00:00
abstract::Intracellular pathogens present a major health risk because of their innate ability to evade clearance. Their location within host cells and ability to react to the host environment by mutation or transcriptional changes often enables survival mechanisms to resist standard therapies. Host-directed drugs do not target ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2013.845524
更新日期:2013-11-01 00:00:00
abstract:INTRODUCTION:Sepsis-associated encephalopathy (SAE) and septic encephalitis (SE) are associated with increased mortality, long-term cognitive impairment, and focal neurological deficits. AREAS COVERED:The PUBMED database was searched 2016-2020. The clinical manifestation of SAE is delirium, SE additionally is characte...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章
doi:10.1080/14787210.2020.1812384
更新日期:2020-09-14 00:00:00
abstract::Despite significant advances in the day-to-day management of patients receiving hematopoietic stem cell transplantations, including the introduction of new antiviral drugs, cytomegalovirus (CMV) infection continues to be a major cause of morbidity and mortality. The aim of this article is to undertake a literature-bas...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.12.115
更新日期:2012-11-01 00:00:00
abstract::This report, completed in November 2003, is intended to serve as a resource for physicians, public health officials and organizations involved in the evaluation and treatment of Lyme disease. ...
journal_title:Expert review of anti-infective therapy
pub_type: 指南,杂志文章,实务指引
doi:10.1586/14789072.2.1.s1
更新日期:2004-01-01 00:00:00
abstract::Having available tools to determine the prognosis of pediatric meningococcal sepsis at admission to the Intensive Care Unit or during the course of the disease constitutes a clinical necessity. Recently, new readily measurable circulating biomarkers have been described as an additional tool for severity classification...
journal_title:Expert review of anti-infective therapy
pub_type: 社论
doi:10.1586/14787210.2014.945431
更新日期:2014-09-01 00:00:00
abstract::Multidrug chemotherapy for 6-9-months is one of the primary treatments in effective control of tuberculosis, although the mechanisms underlying the persistence of its etiological agent, Mycobacterium tuberculosis, against antibiotics remain unclear. Ever-mounting evidence indicates that the survival of many environmen...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.12.88
更新日期:2012-09-01 00:00:00
abstract::Carbapenem-resistant Klebsiella pneumoniae causes serious nosocomial infections and therapeutic options are limited. There is increasing evidence suggesting that combination antibiotic therapy is more effective than monotherapy and leads to better outcomes. However, questions remain about which regimen is optimal and ...
journal_title:Expert review of anti-infective therapy
pub_type: 社论
doi:10.1586/14787210.2015.1018825
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:We performed a meta-analysis to determine diagnostic accuracy of Xpert MTB/RIF for diagnosis of abdominal (intestinal or peritoneal) tuberculosis (TB) in various tissues (intestinal, omental/peritoneal tissue or ascitic fluid). METHODS:Electronic databases were searched for observational studies on use of X...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章
doi:10.1080/14787210.2020.1816169
更新日期:2020-08-26 00:00:00
abstract::As a consequence of antibiotic overuse and misuse, nosocomial infections caused by multidrug-resistant bacteria represent a physician's nightmare throughout the world. No newer antimicrobials active against Pseudomonas aeruginosa, the main multidrug-resistant nosocomial pathogen, are available or under investigation. ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.4.4.601
更新日期:2006-08-01 00:00:00
abstract::The true incidence of pulmonary bacterial coinfection in infants and children hospitalized with a viral respiratory infection is difficult to ascertain but can vary widely from under 1 to 44%. For the same patient group admitted to pediatric intensive care units and/or requiring ventilatory support, the evidence is mo...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.12.80
更新日期:2012-08-01 00:00:00
abstract:INTRODUCTION:Listeriosis is an uncommon foodborne infection that may cause moderate maternal illness, but can be extremely serious for the fetus and the newborn. Several guidelines have been elaborated in order to help clinicians on the care of pregnant women with known or suspected exposure to Listeria monocytogenes. ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2018.1417837
更新日期:2018-01-01 00:00:00
abstract::Coinfection with hepatitis C in HIV-infected patients has been reported in 15-70% of patients depending on the mode of acquisition of both viruses. As recent advances in HIV-directed antiviral therapy have markedly delayed HIV progression and mortality, the incidence of complications arising from hepatitis C-associate...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.1.3.433
更新日期:2003-10-01 00:00:00
abstract::Sepsis in older adults has many challenges that affect rate of septic diagnosis, treatment, and monitoring parameters. Numerous age-related changes and comorbidities contribute to increased risk of infections in older adults, but also atypical symptomatology that delays diagnosis. Due to various pharmacokinetic/pharma...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2016.1135052
更新日期:2016-01-01 00:00:00
abstract::Bacillus anthracis is the causative agent of anthrax, a disease that plagues both humans and various animal species. Effective vaccines are available, but those approved for human use are crude culture supernatants that require multiple injections and a yearly boost. Many experts agree that it is now time for the next...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.7.2.219
更新日期:2009-03-01 00:00:00
abstract::Since the discovery of HIV 30 years ago, we have learned much about HIV in children and adolescents. Dramatic declines have occurred in mother-to-child transmission of HIV in resource-rich countries. Resource-poor countries struggle with improving prevention of mother-to-child transmission due to the lack of universal...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.12.60
更新日期:2012-07-01 00:00:00
abstract::Human enteritis resulting from the consumption of poultry products contaminated with serovars of Salmonella enterica remains a major public-health concern. Reducing food contamination by preventing or controlling infection in the chicken during rearing is an attractive solution. An accurate understanding of the mechan...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.5.5.873
更新日期:2007-10-01 00:00:00
abstract::During the 2010 HIV Diagnostics Conference, which took place in Orlando (FL, USA) between 24 and 26 March 2010, salient new data related to three aspects of HIV testing (rapid point-of-care testing, laboratory assays and new technologies) were presented and discussed. A conundrum central to HIV diagnostics in the USA ...
journal_title:Expert review of anti-infective therapy
pub_type:
doi:10.1586/eri.10.48
更新日期:2010-06-01 00:00:00
abstract::Ceftobiprole is among the first of a new generation of cephalosporins with activity against aerobic Gram-negative bacilli, which extends to cefepime-sensitive Pseudomonas aeruginosa, and activity against Gram-positive organisms, which includes methicillin-resistant Staphylococcus aureus. Ceftobiprole is currently unde...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.09.54
更新日期:2009-09-01 00:00:00
abstract:INTRODUCTION:Carbapenem-resistant Enterobacterales (CRE) represent a global public health problem. Precision medicine (PM) is a multicomponent medical approach that should be used to individualize the management of patients infected with CRE. AREAS COVERED:Here, we differentiate carbapenem-producing CRE (CP-CRE) from ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章
doi:10.1080/14787210.2020.1760844
更新日期:2020-08-01 00:00:00
abstract::Ebola and Marburg viruses are emerging/re-emerging pathogens that pose a significant threat to human health. These naturally occurring viral infections frequently cause a lethal hemorrhagic fever in humans and nonhuman primates. The disastrous consequences of infection with these viruses have been pursued as potential...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.4.1.67
更新日期:2006-02-01 00:00:00
abstract::Botulism is a severe neuroparalytic disease resulting from exposure to one of the most poisonous toxins to humans. Because of this high potency and the use of toxins as biological weapons, botulism is a public health concern and each case represents an emergency. Current therapy involves respiratory supportive care an...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2014.945917
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:The identification of factors that can predispose to the development of severe influenza is essential to enable the implementation of optimal prevention and control measures for vulnerable populations. AREAS COVERED:Unfortunately, data in the pediatric age group remain difficult to interpret. However, epi...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2016.1227701
更新日期:2016-10-01 00:00:00
abstract::Ventilator-associated pneumonia (VAP) remains a major burden to the healthcare system and intubated patients in intensive care units. In fact, VAP is responsible for at least 50% of prescribed antibiotics to patients who need mechanical ventilation. One of the factors contributing to VAP pathogenesis is believed to be...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2015.1007045
更新日期:2015-03-01 00:00:00
abstract::Antibiotic resistance is an important factor influencing clinical outcome for patients in intensive care units. It is also associated with increased healthcare costs resulting from prolonged patient stays. The problem of antibiotic resistance is particularly acute in intensive care units because they house seriously i...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.1.2.253
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Hospital antibiotic use is rising. We aimed to evaluate the antibiotic-use prevalence and length of stay. METHODS:We conducted a single-center retrospective study of patients < 18-years-old admitted to general pediatric services who received ≥ 1 antibiotic over six months. Demographics, culture results and ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章
doi:10.1080/14787210.2020.1787833
更新日期:2020-11-01 00:00:00
abstract::The 6th World Congress of the World Society for Pediatric Infectious Diseases (WSPID), which was recently held in Buenos Aires, Argentina, between 18 and 22 November 2009, attracted 2401 attendees from 90 countries representing six continents. The WSPID, founded in 1994 by Professor Saldana Gonzalez of the Mexican Ped...
journal_title:Expert review of anti-infective therapy
pub_type:
doi:10.1586/eri.10.6
更新日期:2010-03-01 00:00:00
abstract::Introduction: Among the multidrug resistant pathogens, extended-spectrum beta-lactamase (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE) are currently considered the main threat due to the scarcity of therapeutic options and their rapid spread around the globe. In addition to developing new antibiotics and...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2019.1645007
更新日期:2019-08-01 00:00:00
abstract:INTRODUCTION:Drug concentrations in tuberculosis patients on standard regimens vary widely with clinically important consequences. Areas covered: We review the available literature identifying factors correlated with pharmacokinetic variability of antituberculosis drugs. Based on population pharmacokinetic models and t...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2019.1555031
更新日期:2019-01-01 00:00:00