DAMPAK KETEPATAN WAKTU TERAPI ANTIBIOTIK PADA HASIL PASIEN DENGAN SEPSIS DAN SYOK SEPTIK

Stevany Angelia(1*), Ivans Panduwiguna(2),

(1) RSUD Jati Padang
(2) STIKES Buleleng

(*) Corresponding Author

Abstract


Terdapat perbedaan pendapat mengenai target waktu terapi antibiotik pada pasien dengan sepsis. Beberapa penelitian menunjukkan bahwa pemberian antibiotik sejak dini mengurangi angka kematian akibat sepsis. Namun, penelitian lain tidak menemukan hubungan antara terapi antibiotik dini dan hasil pengobatan pasien. Terdapat perbedaan pendapat terkait target waktu terapi antibiotik yang tepat pada pasien sepsis yang mendorong kami untuk melakukan sistematic review untuk mengidentifikasi target waktu penggunaan antibiotik yang terkait dengan hasil yang menguntungkan. Kami melakukan pencarian pada empat data base (PubMed, EMBASE, ScienceDirect, dan Cochrane Library) untuk hasil penelitian cohort (retrospektif dan atau propektif) yang relevan terkait dampak waktu terapi antibiotik yang tepat pada pasien sepsis dan syok sepsis. Kami memasukan 7 penelitian yang sesuai yang melibatkan 19.364 pasien pada semua kelompok sepsis. Empat penelitian memberikan informasi mengenai kesesuaian terapi antibiotik pada 5.870 pasien. Tiga penelitian melaporkan adanya hubungan antara waktu penggunaan antibiotik dan kematian. Ambang waktu yang terkait dengan hasil akhir pasien terdiri dari berbagai batas waktu (1 jam, 125 menit, 3 jam atau 6 jam) dalam 6 penelitian, time to-antibiotik (pemberian dilakukaan saat masuk UGD) dalam 1 penelitian. Kesimpulan: Meskipun tiga penelitian sepsis melaporkan adanya hubungan antara pemberian terapi antibiotik dini dan outcome pasien, matriks waktu pemberian antibiotik bervariasi secara signifikan antar penelitian dan tidak ada batasan waktu pasti yang muncul.

Keywords


Sepsis, Syok Sepsis, Terapi Antibiotik

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References


WHO. Sepsis. World Health Organitation 2023. https://www.who.int/health-topics/sepsis#tab=tab_1 (accessed January 21, 2024).

Evans T. Diagnosis and Management of Sepsis. CME INFECTIOUS DISEASES Clinical Medicine 2017;17:146–55.

Levy MM, Evans LE, Rhodes A. The Surviving Sepsis Campaign Bundle: 2018 update. Intensive Care Med 2018;44:925–8. https://doi.org/10.1007/s00134-018-5085-0.

Gaieski DF, Mikkelsen ME, Band RA, Pines JM, Massone R, Furia FF, et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med 2010;38:1045–53. https://doi.org/10.1097/CCM.0b013e3181cc4824.

Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med 2021;47:1181–247. https://doi.org/10.1007/s00134-021-06506-y.

Yang A, Kennedy JN, Reitz KM, Phillips G, Terry KM, Levy MM, et al. Time to treatment and mortality for clinical sepsis subtypes. Crit Care 2023;27:1–10. https://doi.org/10.1186/s13054-023-04507-5.

Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006;34:1589–96. https://doi.org/10.1097/01.CCM.0000217961.75225.E9.

Singer M. Antibiotics for Sepsis: Does Each Hour Really Count, or Is It Incestuous Amplification? Am J Respir Crit Care Med 2017;196:800–2. https://doi.org/10.1164/rccm.201703-0621ED.

Mi MY, Klompas M, Evans L. Early Administration of Antibiotics for Suspected Sepsis. New England Journal of Medicine 2019;380:593–6. https://doi.org/10.1056/NEJMclde1809210.

Singer M, Inada-Kim M, Shankar-Hari M. Sepsis hysteria: excess hype and unrealistic expectations. Lancet 2019;394:1513–4. https://doi.org/10.1016/S0140-6736(19)32483-3.

Klompas M, Calandra T, Singer M. Antibiotics for Sepsis-Finding the Equilibrium. JAMA 2018;320:1433–4. https://doi.org/10.1001/jama.2018.12179.

Kalil AC, Gilbert DN, Winslow DL, Masur H, Klompas M. Infectious Diseases Society of America (IDSA) POSITION STATEMENT: Why IDSA Did Not Endorse the Surviving Sepsis Campaign Guidelines. Clinical Infectious Diseases 2018;66:1631–5. https://doi.org/10.1093/cid/cix997.

Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992;101:1644–55. https://doi.org/10.1378/chest.101.6.1644.

Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;31:1250–6. https://doi.org/10.1097/01.CCM.0000050454.01978.3B.

Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016;315:801–10. https://doi.org/10.1001/jama.2016.0287.

Calandra T, Cohen J. The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit Care Med 2005;33:1538–48. https://doi.org/10.1097/01.ccm.0000168253.91200.83.

Peltan ID, Brown SM, Bledsoe JR, Sorensen J, Samore MH, Allen TL, et al. ED Door-to-Antibiotic Time and Long-term Mortality in Sepsis. Chest 2019;155:938–46. https://doi.org/10.1016/j.chest.2019.02.008.

Husabø G, Nilsen RM, Flaatten H, Solligård E, Frich JC, Bondevik GT, et al. Erratum: Early diagnosis of sepsis in emergency departments, time to treatment, and association with mortality: An observational study (PLoS ONE (2020) 15: 1 (e0227652) DOI: 10.1371/journal.pone.0227652). PLoS One 2021;16:1–15. https://doi.org/10.1371/journal.pone.0248879.

Ko BS, Choi SH, Kang GH, Shin TG, Kim K, Jo YH, et al. Time to Antibiotics and the Outcome of Patients with Septic Shock: A Propensity Score Analysis. American Journal of Medicine 2020;133:485-491.e4. https://doi.org/10.1016/j.amjmed.2019.09.012.

Ascuntar J, Mendoza D, Jaimes F. Author’s response to letter “antimicrobials administration time in patients with suspected sepsis: Faster is better for severe patients.” J Intensive Care 2020;8:1–10. https://doi.org/10.1186/s40560-020-00472-1.

Abe T, Kushimoto S, Tokuda Y, Phillips GS, Rhodes A, Sugiyama T, et al. Implementation of earlier antibiotic administration in patients with severe sepsis and septic shock in Japan: A descriptive analysis of a prospective observational study. Crit Care 2019;23:1–11. https://doi.org/10.1186/s13054-019-2644-x.

Seok H, Song J, Jeon JH, Choi HK, Choi WS, Moon S, et al. Timing of antibiotics in septic patients: a prospective cohort study. Clinical Microbiology and Infection 2020;26:1495–500. https://doi.org/10.1016/j.cmi.2020.01.037.

Castaño P, Plaza M, Molina F, Hincapié C, Maya W, Cataño J, et al. Antimicrobial agent prescription: a prospective cohort study in patients with sepsis and septic shock. Tropical Medicine and International Health 2019;24:175–84. https://doi.org/10.1111/tmi.13186.

Korang SK, Safi S, Nava C, Gordon A, Gupta M, Greisen G, et al. Antibiotic regimens for early-onset neonatal sepsis. Cochrane Database Syst Rev 2021;5:CD013837. https://doi.org/10.1002/14651858.CD013837.pub2.

San Geroteo J, Levy M, Gotchac J, Brissaud O, Dauger S. Fluid bolus therapy in pediatric sepsis: a narrative review. Eur J Med Res 2022;27:246. https://doi.org/10.1186/s40001-022-00885-8.

Dumortier J, Guillaud O, Valette P-J, Partensky C, Paliard P, Boillot O, et al. Prophylactic sequential antibiotic therapy for recurrent liver/biliary sepsis. Clin Res Hepatol Gastroenterol 2022;46:101979. https://doi.org/10.1016/j.clinre.2022.101979.

Vincent J-L. Current sepsis therapeutics. EBioMedicine 2022;86:104318. https://doi.org/10.1016/j.ebiom.2022.104318.

Richter DC, Heininger A, Brenner T, Hochreiter M, Bernhard M, Briegel J, et al. Bacterial sepsis : Diagnostics and calculated antibiotic therapy. Anaesthesist 2019;68:40–62. https://doi.org/10.1007/s00101-017-0396-z.

Bhat BV. Fine-Tuning the Duration of Antibiotic Therapy for Neonatal Sepsis. Indian J Pediatr 2022;89:323–4. https://doi.org/10.1007/s12098-021-04063-2.




DOI: https://doi.org/10.31596/jkm.v12i1.2153

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