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J Korean Med Assoc > Volume 62(12); 2019 > Article
Journal of the Korean Medical Association 2019;62(12):638-644.
Published online December 17, 2019.
DOI: https://doi.org/10.5124/jkma.2019.62.12.638   
Optimal antimicrobial therapy and antimicrobial stewardship in sepsis and septic shock
Hyeri Seok, Dae Won Park
Division of Infectious Diseases, Department of Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. pugae1@korea.ac.kr
Abstract
The management of sepsis and septic shock remains challenging. The aim is to apply the optimal antimicrobial therapy and antimicrobial stewardship to patients in state of sepsis or septic shock. To reduce the mortality of sepsis and septic shock, it is critical to promptly administer the appropriate antibiotics with an accurate diagnosis. De-escalation is needed 48 to 72 hours after the first administration of antibiotics depending on the findings of causative pathogens. In the case of antibiotic resistance, the importance of an antibiotic stewardship program is increasingly being emphasized. Antimicrobial stewardship implies coordinated interventions designed to improve the appropriate use of antibiotics by promoting the selection of an optimal drug regimen such as dosing, duration of therapy, and route of administration. An antibiotic stewardship program may also be applied to patients of both sepsis and septic shock. Efforts such as the selection of appropriate empirical antibiotics, de-escalation, and determination of whether to stop antibiotics with procalcitonin may improve the clinical prognosis of patients with sepsis as well as the successful implementation of an antibiotic stewardship program.
Key Words: Sepsis, Septic shock, Anti-infective agents, Anti-bacterial agents, Antibiotic stewardship
 
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