An intensive retrospective study conducted in Hirosaki University Hospital, Japan, aimed to identify key practices related to patient survival with sepsis. The study explored factors associated with 30-day mortality in sepsis patients, with a particular focus on antimicrobial use, in order to provide guidance for antimicrobial stewardship teams (AST).
The study analyzed a decade’s data (2010 to 2020) involving 1406 patients diagnosed with pathogen-identified sepsis, examining multiple factors including clinical and microbiological data, antibiotics used in empirical and definitive therapies, and inappropriate or ineffective antimicrobial use.
Analysis showed a significant association between the inefficient use of antibiotics in empirical therapy, under-prescription in definitive therapy, and increased 30-day mortality rates in sepsis patients. Additionally, repeated blood culture sampling appeared to reduce the incidence of inappropriate antimicrobial use.
Over the ten years, the 30-day mortality rate consistently fell; an improvement that coincided with an increase in the practice of multiple blood culture sampling and de-escalation of therapy. In tandem, inappropriate use of antimicrobials decreased during this period.
The paper concluded that essential strategies for minimizing the 30-day mortality rate among sepsis patients include ensuring frequent blood culture sampling, proper selection of antimicrobials, and establishing the correct dosage for definitive therapy.
These clinically significant findings suggest that ASTs could provide valuable support in implementing best practices for sepsis treatment. They highlight the potential for reduced mortality in sepsis patients when the use of antimicrobials is optimized, providing decisive pointers for healthcare professionals concerned with infection control and prevention.
This study reflects the challenging landscape of sepsis management, especially where infectious disease specialists are in short supply. As illustrated by Hirosaki University Hospital, limited availability of such specialists can lead to suboptimal or inappropriate use of antibiotics, causing potentially serious consequences such as increased mortality. However, with diligence and a patient-centered approach from the AST, these issues can be mitigated leading to improved patient outcomes.
The findings are particularly significant for regional hospitals located far from major cities, such as Hirosaki University Hospital, where resources for specialist care can be scarce. In such contexts, the role of well-informed and motivated ASTs, guided by clear strategies and effective practices, becomes essential to improving patient outcomes.