OBJECTIVE: In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for sepsis associated with immunosuppressive medications that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis Campaign, an international effort to increase awareness and improve outcome in severe sepsis. DESIGN: The process included a modified Delphi method, a consensus conference, several subsequent smaller meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. METHODS: The modified Delphi methodology used for grading recommendations built on a 2001 publication sponsored by the International Sepsis Forum. We undertook a systematic review of the literature graded along five levels to create recommendation grades from A to E, with A being the highest grade. Pediatric considerations to contrast adult and pediatric management are in the article by Parker et al. on p. S591. CONCLUSION: Immunosuppressed patients, by definition, are susceptible to a wider spectrum of infectious agents than immunologically normal patients and, thus, require a broader spectrum antimicrobial regimen when they present with sepsis or septic shock. Special expertise managing immunosuppressed patient populations is needed to predict and establish the correct diagnosis and to choose appropriate empiric and specific agents and maximize the likelihood that patients will survive these microbial challenges.
OBJECTIVE: In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for sepsis associated with immunosuppressive medications that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis Campaign, an international effort to increase awareness and improve outcome in severe sepsis. DESIGN: The process included a modified Delphi method, a consensus conference, several subsequent smaller meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. METHODS: The modified Delphi methodology used for grading recommendations built on a 2001 publication sponsored by the International Sepsis Forum. We undertook a systematic review of the literature graded along five levels to create recommendation grades from A to E, with A being the highest grade. Pediatric considerations to contrast adult and pediatric management are in the article by Parker et al. on p. S591. CONCLUSION: Immunosuppressed patients, by definition, are susceptible to a wider spectrum of infectious agents than immunologically normal patients and, thus, require a broader spectrum antimicrobial regimen when they present with sepsis or septic shock. Special expertise managing immunosuppressed patient populations is needed to predict and establish the correct diagnosis and to choose appropriate empiric and specific agents and maximize the likelihood that patients will survive these microbial challenges.
Authors: Christine D Palmer; Christy J Mancuso; Jerrold P Weiss; Charles N Serhan; Eva C Guinan; Ofer Levy Journal: J Leukoc Biol Date: 2011-06-07 Impact factor: 4.962
Authors: Abdullah Chahin; Steven M Opal; Jorge Zorzopulos; David V Jobes; Yazan Migdady; Michelle Yamamoto; Nicholas Parejo; John E Palardy; David L Horn Journal: Antimicrob Agents Chemother Date: 2014-12-15 Impact factor: 5.191
Authors: John P Donnelly; Jayme E Locke; Paul A MacLennan; Gerald McGwin; Roslyn B Mannon; Monika M Safford; John W Baddley; Paul Muntner; Henry E Wang Journal: Clin Infect Dis Date: 2016-05-23 Impact factor: 9.079
Authors: Saravanan Ramamoorthy; Shachi Patel; Eric Bradburn; Zakiyah Kadry; Tadahiro Uemura; Piotr K Janicki; Riaz Ali Shah; Dmitri Bezinover Journal: Case Rep Transplant Date: 2013-05-13