Early Infectious Disease Consult Helps Cut Sepsis Death Risk

Early infectious diseases consultation is linked to a reduction in in-hospital mortality for patients receiving severe sepsis and septic shock treatment bundle, reports a new study.

When caregivers consult with an infectious disease physician early on in a sepsis patient’s treatment, the patient’s death risk can be decreased by up to 40 percent, according to a new study. The findings of the study are published in the journal Open Forum Infectious Diseases.

"If you or a loved one has a serious infection, including sepsis, then having an infectious disease physician as part of the team of doctors that cares for you will probably result in better outcomes," said lead study author Theresa Madaline, MD, assistant professor of Medicine at Albert Einstein College of Medicine and Healthcare Epidemiologist at Montefiore Health System in New York City. "You should ask to have an infectious disease physician see you if that is available at your hospital."

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‘The in-hospital death rate was 40 percent lower among patients with severe sepsis and septic shock, whose care team discussed with an infectious disease specialist within 12 hours of their arrival to the ER. ’
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The study, which included 248 ER patients with severe sepsis seen from 2017 to 2018 at Montefiore Health System’s Jack D. Weiler Hospital, also found that antibiotic prescriptions for these patients were stopped more quickly when an ID consult happened early. While antibiotics may be lifesaving initially, they can cause harmful side effects, particularly when taken for long periods. Diagnostic test results can help guide and refine antibiotic treatment over time, so medications can be decreased, as appropriate.

"It’s very important to use antibiotics for the shortest amount of time that is appropriate in order to spare the patient potential negative effects of the medication," Dr. Madaline said. "That’s really a crucial way infectious diseases consultation makes a difference."

Unlike previous research in this area, the new study focused only on patients who received the recommended care for severe sepsis within three hours. This allowed the researchers to specifically hone in on the clinical benefit of early consultation with an ID specialist and separate it from improved adherence to recommended standards, which can also positively effect patient outcomes.

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World Sepsis Day (WSD) is observed on the 13th September to raise public awareness about sepsis, a serious and potentially fatal complication of untreated infections, which can be easily prevented with early diagnosis and appropriate treatment.

The continuity that ID physicians are able to provide as a patient with severe sepsis transitions from one team of caregivers in the ER to another elsewhere in the hospital may provide care teams a greater degree of confidence when deciding to stop antibiotic treatment.

Additional research is needed to quantify how early ID consultation affects this decision-making process and to identify what aspects of having these specialists involved initially in a patient’s care are most meaningful, Dr. Madaline said.

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In the meantime, the new findings add to the growing evidence that ID physicians have a beneficial impact on outcomes for patients with sepsis and other infection-related conditions.

"Infectious disease specialists are excellent partners for other physicians in different specialties who care for patients," Dr. Madaline said. "It is important to continue to pursue research on how ID specialists can best partner with other providers to optimize patient outcomes, and how early consultation models can be tailored in different environments. Diagnosing and treating severe sepsis can be a huge challenge, so it is important to remember that there is ’no one size fits all’ model for improving outcomes for people impacted by this condition."

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Source-Eurekalert