D. Nathwani et P. Davey, STRATEGIES TO RATIONALIZE SEPSIS MANAGEMENT - A REVIEW OF 4 YEARS EXPERIENCE IN DUNDEE, The Journal of infection, 37, 1998, pp. 10-17
Hospitals worldwide are facing an unprecedented crisis of rising cost
of antibacterials due to the increasing rapid emergence and dissemenat
ion of antibiotic-resistant organisms, improper use of antibiotics and
the use of broad spectrum parenteral agents. The last 25 years has se
en the introduction of many measures to improve the quality of sepsis
management, and specifically antimicrobial use. The present paper revi
ews the development, implementation and evaluation of some of the key
strategies employed within the Dundee Teaching Hospitals NHS Trust (DT
HT) to enhance recognition and assessment of sepsis and to rationalize
the early and often empiric antibiotic treatment of patients in hospi
tal with infection. Particular emphasis is given to optimizing the use
of expensive parenteral agents in conjunction with promotion of oral
switch therapy where appropriate.