Early identification and treatment of septic shock to save lives

June 1, 2012

(Medical Xpress) -- Recognition of severe septic shock early and starting a patient on an effective antibiotic treatment immediately is critical to saving lives, according to an editorial by two Virginia Commonwealth University physicians published in the May 31 issue of the New England Journal of Medicine.

In the editorial, Richard P. Wenzel, M.D., professor in the Department of in the VCU School of Medicine, and Michael B. Edmond, M.D., M.P.H., chair of the Division of , noted that approximately 20 adjuvant drugs, apart from , have failed in trials of in the last two decades. They concluded that new therapies will emerge only from a “more crystalline view of the biology of sepsis.”

Wenzel and Edmond based their observations on a multi-institutional study of a controversial drug for sepsis known as drotrecogin alfa. According to Wenzel and Edmond, the weight of evidence now should “end any further pursuit of a niche for Human Activated Protein C in sepsis.”

According to Wenzel, an initial study in 2001 of the drug showed modest success in treating sepsis. However, the favorable outcome of slightly reduced mortality could not be replicated in lower risk adult patients or in children with sepsis. The international team testing the new drug proceeded to enroll a large number of patients with the most severe stage of sepsis - - and waited for at least four hours of shock to enroll them. The drug had no effect on mortality different from the placebo. However, both study groups received antibiotic therapy.

Based on their analysis, Wenzel and Edmond noted that in studying mortality from an acute infection like sepsis, investigators fail to consider the component of death from infection separate from the component from underlying diseases.

“In other words, some people die with sepsis but not from it, and they die because they have serious underlying diseases like lung or heart disorders or cancer,” said Wenzel.

The VCU team showed that failing to consider each component leads to errors in calculating the necessary number of subjects in a clinical trial. However, Wenzel and Edmond also said that the trends in the recent trial were slightly in favor of placebo being safer that the drug.

Explore further: Clinical trial to treat septic shock under way at UMC

Related Stories

Clinical trial to treat septic shock under way at UMC

June 1, 2011
The death rate can be as high as 60 percent for people with underlying medical problems, and some 250,000 Americans die of severe sepsis annually.

BUSM: Severe sepsis, new-onset AF associated with increased risk of hospital stroke, death

November 13, 2011
A recent study led by researchers at Boston University School of Medicine (BUSM) shows an increased risk of stroke and mortality among patients diagnosed with severe sepsis and new-onset atrial fibrillation (AF) during hospitalization.

Nationwide trends for sepsis in the 21st century

August 18, 2011
Severe sepsis is common and often fatal, although evidence-based therapies have improved patient outcomes.

Combination antibiotic treatment does not result in less organ failure in adults with severe sepsis

May 21, 2012
Frank M. Brunkhorst, M.D., of Friedrich-Schiller University, Jena, Germany, and colleagues conducted a study to compare the effect of the antibiotics moxifloxacin and meropenem with the effect of meropenem monotherapy on ...

Recommended for you

Study suggests ending opioid epidemic will take years

July 20, 2017
The question of how to stem the nation's opioid epidemic now has a major detailed response. A new study chaired by University of Virginia School of Law Professor Richard Bonnie provides extensive recommendations for curbing ...

Team-based model reduces prescription opioid use among patients with chronic pain by 40 percent

July 17, 2017
A new, team-based, primary care model is decreasing prescription opioid use among patients with chronic pain by 40 percent, according to a new study out of Boston Medical Center's Grayken Center for Addiction Medicine, which ...

Private clinics' peddling of unproven stem cell treatments is unsafe and unethical

July 7, 2017
Stem cell science is an area of medical research that continues to offer great promise. But as this week's paper in Science Translational Medicine highlights, a growing number of clinics around the globe, including in Australia, ...

Popular heartburn drugs linked to higher death risk

July 4, 2017
Popular heartburn drugs called proton pump inhibitors (PPIs) have been linked to a variety of health problems, including serious kidney damage, bone fractures and dementia. Now, a new study from Washington University School ...

Most reproductive-age women using opioids also use another substance

June 30, 2017
The majority of reproductive-age and pregnant women who use opioids for non-medical purposes also use at least one other substance, ranging from nicotine or alcohol to cocaine, according to a University of Pittsburgh Graduate ...

At-risk chronic pain patients taper opioids successfully with psychological tools

June 28, 2017
Psychological support and new coping skills are helping patients at high risk of developing chronic pain and long-term, high-dose opioid use taper their opioids and rebuild their lives with activities that are meaningful ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.