MINIMAL ANTIBIOTIC-THERAPY - TECHNOLOGY-ASSESSMENT INSTEAD OF CLINICAL-TRIALS

In modern medicine which already uses maximal resources, additional im provements involve huge extra efforts. With increasing complexity of d iseases, specific treatments have only a limited influence on the ''wh ole process''. In complex clinical situations (including sepsis and SI RS) the available methodology to identify groups of patients who may b enefit from a specific treatment are weak. This is why prospective ran domised ''megatrials'' may be needed to detect small differences in ou tcome. We suggest that careful prospective assessment of cohorts of we ll stratified patients, subjected to a specific and standardised treat ment, may replace prospective controlled trials.