Sepsis and antibiotics: the debate goes on
Reviewed by Arun K Sharma

Sepsis statistics are staggering around the world. The UK Sepsis Trust estimates that there are around 150,000 cases of sepsis in the UK every year and it kills 44,000 patients per year. There are many different definitions and criteria; in the UK Sepsis Six is used while in the USA it is Sepsis-3 and qSOFA. Various slogans are also used e.g. Suspect Sepsis: Think Bufalo (blood culture, urine output, fluids, antibiotics, lactate, oxygen). The use of antibiotics, as well as timing, is also debatable. The National Institute for Health & Care Excellence (NICE) recommends giving antibiotics within one hour for high-risk patients. But microbiologists argue that the pros and cons should be considered for each case as the injudicious use of antibiotics can cause more harm than good. Frontline staff (junior doctors and nurses) should be encouraged to review antibiotic use within 72 hours. This paper is of great interest to all urologists, as we deal with urosepsis day in and day out. 

Sepsis and antibiotics: finding the right balance.
Torjesen I.
BMJ
2016;354:i4209.