THE RECENT TRENDS IN USING ANTIMICROBIAL DRUGS IN MANAGEMENT OF SEPSIS IN INTENSIVE CARE UNIT

Abstract

Sepsis is a common and serious disease with substantial morbidity and mortality despite recent advances in supportive care and disease-specific treatments. It is defined as an infection with concurrent systemic manifestations that are the result of the host response. This response, known as systemic inflammatory response syndrome (SIRS). Gram negative bacilli (mainly Escherichia coli, Klebsiella species, and Pseudomonas aeruginosa) and Gram positive cocci (mainly staphylococci and streptococci) are the commonest microbes isolated from patients with severe sepsis and septic shock. Fungi, mostly Candida, account for only about 5% of all cases of severe sepsis. Bacterial cell walls, endotoxins, and exotoxins are powerful activators of innate and acquired immune responses, molecules expressed by pathogens interact with Toll-like receptors on immune cells, activating the immune response, cytokines are important in the pathogenesis of sepsis.