Siaarti, targeted antibiotics against sepsis in new anesthesiologists guidelines

In the world, every 3-4 seconds someone dies of sepsis. Starting from this data, in 2024 the Global Sepsis Alliance has decided to focus the message to be spread on World Sepsis Day, which is celebrated on September 13. On this occasion, the Italian Society of Anaesthesia Analgesia Resuscitation and Intensive Care (Siaarti) presents, in a free webinar on the YouTube channel of the scientific society, the new guidelines that address the need to quickly start a targeted antibiotic therapy to reduce mortality related to this condition. Watch the video: https://youtu.be/Jwf7n60N0DE

Sepsis – we read in a note – occurs when the immune response to an infection, such as pneumonia or diarrhea, causes damage to organs and tissues and affects 47-50 million people every year, causing more than 11 million deaths: 1 in 5 deaths worldwide is associated with sepsis. “This is a real health emergency that – explains Antonino Giarratano, president of Siaarti – in Italy alone, affects about 250 thousand people a year, with a mortality rate of 25% (about 50 thousand deaths in 2015, 70 thousand in 2020, the year of Covid). For this reason, Siaarti, since 2021, has been committed to developing a multidisciplinary guideline on the management of sepsis and septic shock in adult patients, together with other scientific societies such as those of microbiologists (Amcli and Sim), infectious disease specialists (Simit and Sita), emergency-urgency doctors (Simeu) and pharmacologists (Sif)”.

The work “has been very long – adds Andrea Cortegiani, head of the Siaarti Scientific Committee and member of the panel of experts who developed the document – and the guideline finally saw the light in July 2024, when it was published on the website of the Istituto Superiore di Sanità. In view of the anniversary of World Sepsis Day, we thought it appropriate to organize a webinar to present the document, which will remain available online in the following months”. The event is available for free on the Siaarti YouTube channel (https://youtu.be/Jwf7n60N0DE) and sees the comparison between anesthesiologists-resuscitators, infectious disease specialists and microbiologists. “The guideline – specifies Daniela Pasero, head of the Siaarti ‘Infections and sepsis’ section and moderator of the webinar – underlines the importance of reducing diagnostic time (Turn-around-time) thanks to rapid tests, to quickly identify the pathogen and its resistance to antibiotics”. In fact, “sepsis is a time-dependent disease – observes Gianpaola Monti, head of the Siaarti scientific committee – Early diagnosis and timely initiation of targeted therapy are crucial to reduce mortality. A rapid diagnosis also allows us to avoid excessive exposure to antibiotics, which can lead to the development of antibiotic resistance and reduce the adverse effects of antimicrobials”.

In Italy, antibiotic resistance is among the highest in Europe. Every year, almost 300,000 patients contract infections from resistant bacteria, with approximately 7,000 deaths. “Antibiotics,” explains Marco Falcone, an infectious disease specialist, “are prescribed too often without adequate training and without any utility, both in the community and in hospital. In the case of sepsis, antibiotics are essential and it is necessary to choose the right one based on rapid microbiological findings, both in terms of identifying the germ and the resistance mechanisms.” As microbiologist Stefania Stefani points out, “research and analysis of the literature demonstrate that rapid microbial identification improves the outcome in patients with sepsis. Despite the more limited number of studies, the use of rapid tests is the direction to follow also for the antibiogram.”

The Siaarti Guidelines indicate a clear path, but it is necessary to invest in adequate training and in the organization of analysis laboratories, which should guarantee an increasingly extended activity throughout the day, to guarantee timely diagnoses. A faster and more efficient management of antibiotic therapy – the note concludes – would not only reduce mortality, but would also reduce healthcare costs, improving the care of critical patients and shortening hospitalization times.