Testing applicability of international guidelines in treatment of sepsis

摘要

Introduction. The Department of Infectious Diseases adopted new internal clinical protocols for initial adequate antimicrobial therapy of bacterial infections in January, 2013. Protocols were made up on the basis of European (British National Formulary) and the American (Sanford) guidelines for treatment of bacterial infections. The aim of our study was to investigate the efficiency of new clinical protocols based on international guidelines in treatment of bacteria induced sepsis and to compare it with the efficiency of the existing guidelines, which are based on the use of antibiotics according to clinical experience of the doctors. Material and Methods. The study included 109 patients diagnosed with bacteria-induced sepsis, who were treated at the Department of Infectious Diseases in the period from 1 January, 2012 to 31 December, 2013. Data were collected from the medical records. The patients were divided into two groups. The first group included 54 patients diagnosed with sepsis who were treated empirically. The second group consisted of 55 patients treated according to the new internal protocols. The efficiency of treatment in both groups of patients was monitored by laboratory findings (leukocyte count, C-reactive protein, fibrinogen, sedimentation, procalcitonin), and temperatures, measured on the first and seventh day of hospitalization. For statistical analysis, we used the χ2 test. Results. After the applied treatment, there was a statistically significant decrease in the mean values of C-reactive protein P and procalcitonin on the seventh day of treatment in both groups of patients. The most frequently applied therapy was triple antibiotic therapy - ceftriaxone, ciprofloxacin and metronidazole, in both groups. Conclusion. Treatment of bacteria-induced sepsis according to internationally accepted protocols for treatment of bacterial infections is as effective as treatment of sepsis according to the clinical experience of doctors.