Undertreatment of sepsis can lead to mortality, while overdiagnosis and overtreatment can increase future risk of antimicrobial resistance. Antimicrobial stewardship aims to balance these risks by prioritizing patient safety and appropriate antimicrobial use. Data shows variability in appropriateness of antimicrobial prescribing between different types of hospitals. Embedding antimicrobial stewardship principles throughout sepsis diagnosis and treatment, from initial microbiology testing to post-treatment review, can help standardize care and optimize outcomes.

1. SEPSIS
AND ANTIMICROBIAL
STEWARDSHIP
KARIN THURSKY @NCAS_Aus

4. TIME DEPENDENT PROTOCOLS
UNDERTREATMENT OF SEPSIS LEADS TO
MORTALITY
FEAR
OVER DIAGNOSIS
OVER TREATMENT
FUTURE RISK OF AMR
COMPLACENCY
AMS IS ABOUT PATIENT SAFETY FIRST
THE CHALLENGE OF SEPSIS

5. IT’S NOT JUST ABOUT
ANTIBIOTICS!

6. APPROPRIATENESS OF ANTIMICROBIAL
PRESCRIBING (N=NUMBER OF PRESCRIPTIONS FOR SEPSIS INDICATIONS)
DATA FROM THE NATIONAL ANTIMICROBIAL PRESCRIBING SURVEY
ANNUAL POINT PREVALENCE SURVEYS 2014-2021
(COURTESY : C.Ierano)
84.0
88.6
82.4
79.9
77.7
70.0
84.3
85.5
85.5
76.8
Public (n=10,084)
Principal referral (n= 4192)
Public acute group A hospitals (n= 3438)
Public acute group B hospitals (n= 656)
Public acute group C hospitals (n= 1181)
Public acute group D hospitals (n= 293)
Private (n= 1,495)
Private acute group A hospitals (n= 573)
Private acute group B hospitals (n= 628)
Private acute group C hospitals (n= 164)

7. EMBEDDING AMS PRINCIPLES IN SEPSIS
SEPSIS IS DUE
TO AN
INFECTION
MICROBIOLOGY
(IE. 2 SETS BLOOD
CULTURES BEFORE
ANTIBIOTICS)
RECOGNITION RESUSCITATION
EMPIRIC
GUIDELINES
(INC. ALLERGY, SEVERITY,
DOSING)
FORMULARY,
APPROVALS
TIMING (1 HOUR)
ESCALATION
ICU REVIEW
SURGERY
(SOURCE CONTROL)
INFECTIOUS
DISEASES
(MULTI-DRUG
RESISTANT
PATHOGENS)
POST ACUTE SEPSIS
ANTIMICROBIAL
STEP-DOWN
PATIENT/CARER
EDUCATION
POST-
DISCHARGE
PLANNING

8. SEPSIS CLINICAL
PATHWAYS

9. A
LEARNING
HEALTH
CARE
SYSTEM
FOR SEPSIS
Aggregate and
analyze the data
Establish metrics
and benchmarking
of appropriateness
Use this data
inform practice
change through
guidelines,
decision
support, clinical
pathways and
toolkits
Collect data from
clinical encounters,
registries, cohorts,
administrative data
Evaluate outcomes of
sepsis programs including
cost-effectiveness, and
appropriateness of
prescribing
Establish
effective
communication
and feedback
to drive
continuous
improvement
WE NEED DATA FOR
ACTION!