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Intensive Care Med Intensive Care Med Intensive Care Medicine 0342-4642 1432-1238 Springer-Verlag Berlin/Heidelberg 2289999 BF01709709 10.1007/BF01709709 Article Treatment of sepsis in an intensive care unit Smith C. C. 12 1 grid.417581.e0000000086784766Department of Medicine, Aberdeen Royal Infirmary, Foresterhill, AB9 2ZB Aberdeen, Scotland 2 grid.415966.9The Infection Unit, City Hospital, Aberdeen, Scotland 1990 16 Suppl 3 S243 S247 © Springer-Verlag 1990This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.The management of severe bacterial sepsis is an integral part of intensive care medicine. Early and appropriate treatment with antimicrobials positively affects mortality and significantly reduces the time spent in both intensive care and the hospital. Drug choice is usually made on a “best guess” basis and instituted prior to receipt of appropriate blood, sputum, urine or drainage culture results. Bactericidal drugs should be given in combination, delivered by intravenous bolus and directed towards broad cover of all likely pathogens. Aminoglycoside/ureidopenicillin combinations are synergistic and widely used — often combined with metronidazole. Aminoglycoside toxicity can be reduced by giving the drug once daily (OD) rather than by traditional multiple daily dosing (MDD) and by measuring peak and trough serum levels. Efficacy is increased by attention to the peak serum level/MIC ratio which determines the response to treatment. Several newer agents have been more recently introduced. These drugs include ceftazidime, imipenem/cilastatin, the quinolones and clavulanic acid/semisynthetic penicillin combinations. Other newer drugs currently under evaluation include aztreonam, teicoplanin, the penems and carbapenems.

nes the response to treatment. Several newer agents have been more recently introduced. These drugs include ceftazidime, imipenem/cilastatin, the quinolones and clavulanic acid/semisynthetic penicillin combinations. Other newer drugs currently under evaluation include aztreonam, teicoplanin, the penems and carbapenems. Key words Severe infectionITU setting“best guess” choiceBactericidal antimicrobialsCombinations vs. monotherapyPrevention of nosocomial infectionissue-copyright-statement© Springer-Verlag 1990