Jouffroy Romain, Vivien Benoît
SAMU de Paris, Service d'Anesthésie Réanimation, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, AP-HP.Centre and Université de Paris, Paris, France.
J Intensive Care. 2020 Jul 22;8:52. doi: 10.1186/s40560-020-00471-2. eCollection 2020.
In a recent report, Ascuntar et al. describes the impossibility to demonstrate a significant association between early antibiotic therapy administration and mortality in sepsis patients. Nevertheless, we believe that some methodological issues deserve their conclusions. First, the objective of the authors of an early antibiotic therapy may be ambitious considering practical daily emergency department limitation. Second, most of patients included in the study appear to suffer from sepsis and not from septic shock, which limits the impact of an early and aggressive management. At last, more than a single intervention such as antibiotic therapy, sepsis treatment is now considered as based on a "bundle of care."
在最近的一份报告中,阿斯昆塔尔等人描述了无法证明早期抗生素治疗与脓毒症患者死亡率之间存在显著关联。然而,我们认为一些方法学问题值得推敲他们的结论。首先,考虑到日常急诊科实际存在的限制,早期抗生素治疗的作者们设定的目标可能过高。其次,该研究纳入的大多数患者似乎患有脓毒症而非感染性休克,这限制了早期积极治疗的影响。最后,如今脓毒症治疗被认为是基于“一系列护理措施”,而非单一的干预措施如抗生素治疗。