ROLE OF BIOMARKERS IN THE MANAGEMENT OF ANTIBIOTIC THERAPY DURING SEPSIS

Abstract

Sepsis is an unusual systemic reaction to what is sometimes an ordinary infection. A hyperinflammatory response is followed by an immune-suppressive phase during which multiple organ dysfunctions is present and the patient is susceptible to nosocomial infection. Biomarkers to diagnose sepsis may allow early intervention which, although primarily supportive, can reduce the risk of death. Although lactate is currently the most commonly used biomarker to identify sepsis, other biomarkers may help to enhance lactate’s effectiveness; these include markers of the hyper-inflammatory phase of sepsis, such as pro-inflammatory cytokines, chemokines, proteins such as C-reactive protein and procalcitonin which are synthesized in response to infection and inflammation and markers of neutrophil and monocyte activation. Recently, markers of the immune-suppressive phase of sepsis, such as anti-inflammatory cytokines, and alterations of the cell surface markers of monocytes and lymphocytes have been examined. Combinations of pro- and anti-inflammatory biomarkers in a multi-marker panel may help identify patients who are developing severe sepsis before organ dysfunction has advanced too far. Combined with innovative approaches to treatment that target the immunosuppressive phase, these biomarkers may help to reduce the mortality rate associated with severe sepsis which, despite advances in supportive measures, remains high.