Current Infectious Disease Reports

, Volume 12, Issue 5, pp 336–344 | Cite as

Early Antimicrobial Therapy in Severe Sepsis and Septic Shock

  • Anand KumarEmail author


The advent of modern antimicrobial therapy following the discovery of penicillin during the 1940s yielded remarkable improvements in the case fatality rates of serious infections, including septic shock. Since then, pathogens have continuously evolved under selective antimicrobial pressure, resulting in a lack of additional significant improvement in clinical effectiveness of antimicrobial therapy of septic shock despite ever more broad-spectrum and potent drugs. In addition, although substantial effort and money were expended on the development of novel nonantimicrobial therapies of sepsis in the past 30 years, clinical progress in this regard has been limited. This article explores the possibility that the key to significant improvement in the outcome of septic shock may lie, in great part, with improvements in delivery of existing antimicrobials. Recognizing the role of delays in administration of antimicrobial therapy in the poor outcomes of septic shock is central to this effort.


Antibiotic Antimicrobial Antifungal Sepsis Septic shock Infection ICU Critical care Treatment Therapy Delay 



No potential conflict of interest relevant to this article was reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Section of Critical Care Medicine, Section of Infectious Diseases, JJ399d, Health Sciences CentreWinnipegCanada

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