It is most often the elderly, pregnant women or people who are already sick or children who are most exposed to sepsis. Moreover, almost half of the cases are children under five years old and it is estimated that fifteen out of a thousand patients will suffer this complication during their hospitalization. However, no one is safe from this little-known and particularly serious illness. Taken together, the figures reach a dizzying number of 48.9 million cases and 11 million deaths in 2017 alone, or 20% of deaths worldwide. To stem this disease which kills more than cancer worldwide, research continues tirelessly.
And indeed, a recent study has just made its contribution by mentioning a very simple therapeutic approach to implement which could save many lives.
Sepsis: what is it exactly?
Sepsis, also known as sepsis, is a severe and life-threatening inflammatory response of the body to infection. It occurs when Pathogens (bacteria, viruses, fungi or parasites) enter the bloodstream and trigger an overreaction of the immune system. This reaction can cause widespread inflammation and damage to tissues and organs.
It most often starts with a localized infection (such as pneumonia, a urinary infection, peritonitis, an abdominal infection and even an infected wound or a poorly cared for tooth), but cases of meningococcal meningitis or staphylococcal toxic shock syndrome linked to the use of tampons or Menstrual cups aren’t uncommon either. Due to lack of care, pathogens can enter the bloodstream, leading to sepsis. The immune system then reacts to the infection with a massive release of cytokines, which causes a generalized inflammation. Inflammation and abnormal blood clotting can then disrupt blood flow.
What are the consequences for the patient?
The risks involved and complications are multiple, and can be very serious, especially in the case of septic shock, the most serious form of sepsis. This can indeed lead to failure of multiple organs simultaneously (lungs, kidneys, heart, etc.). This multiorgan failure then requires intensive care. As mentioned earlier, there is also a high mortality rate and even with treatment, the risk of death remains significant.
And if patients survive, they can suffer from long-term after-effects, such as cognitive impairment, persistent fatigue and chronic pain. Excessive blood clotting also reduces circulation to the extremities and leads to tissue necrosis. This necrosis may therefore require amputation to prevent the spread of infection and save the patient’s life, which also leaves traces.
The research therefore continues for better management of this serious condition. And if rapid treatment is essential, this new study offers a therapeutic avenue that could also make all the difference.
A way to better treat sepsis
According to this study conducted jointly by the University of Queensland and the George Institute for Global Healt (both in Australia) and published on June 12, 2024 in the Journal of the American Medical Association (JAMA), the right care protocol would involve ultimately a very simple change. Clinical trials accompanied by a systematic review demonstrate that continuous administration of an antibiotic rather than in several short injections could save thousands of lives every year.
To reach this conclusion, the researchers sought to determine the optimal concentration of medication to overcome the pathogens causing the infection through clinical trials in more than a hundred hospitals located in several country with thousands of patients and the meta-analysis of previous studies.
However, as Professor Jason Roberts, director of an Australian Research Institute and the Herston Infectious Diseases Institute, explains: “ we discovered that administering these doses of antibiotics by continuous infusion, we can maintain drug concentrations in the patient’s blood and tissues, with a better chance of killing bacteria. This simple intervention uses very common antibiotics. So, even small hospitals in third world countries will be able to implement this change dosing at least as easily as in hospitals that have access to more resources in developed countries. »
Soon in hospitals?
The researchers believe they have obtained significant results thanks to continuous administration, with one life saved per 26 patients treated. They now hope that this research will improve sepsis care and thus increase patients’ chances of survival.
As Professor Jeffrey Lipman, who has studied this subject for more than twenty years, recalls, “ doctors follow international guidelines to treat patients, but for now, these recommendations offer very little certainty about how to administer medications. Thanks to our research program, treatment protocols and guidelines will now be safer. Considering the very simple nature of these findings and the discussions we are having between hospitals, we expect most to adopt these changes immediately. »
For more details, the figures come from the WHO website and the conclusions of this work can be consulted here and on this link.
