The rapid identification and treatment of persons with sepsis and septic shock continues to be a challenge in our medical system. We have made great progress in approaching the critical treatment thresholds in terms of the first few hours after patient presentation, but we all recognize that time is of the essence, and we can not afford to delay critical interventions to save lives from infections.
There are new challenges beyond simply meeting a sepsis “stopwatch” in terms of delivering treatment. Medical providers need to understand the evolving and worsening issue of antibiotic resistance trends in all of our communities, both on an inpatient and outpatient basis. Many bacteria are not going to be effectively treated, even by our most broad-spectrum antibiotics, so early treatment decisions need to be carefully weighed with this in mind. But, while recognizing this concern for resistance, it is still critical for all providers to modify antibiotic therapy as indicated, so as not to add to the furtherance of drug resistance.
Lastly, medical providers in the northeast and notably New York State need to be aware that there is a growing trend with certain infections that can clearly present as sepsis and severe sepsis, that are not managed with the same empiric antibiotics used in most sepsis protocols. Two tick borne infections, Anaplasmosis and Babesiosis, have strong and growing footholds throughout New York State, may present with very critical features, and both require a methodical diagnostic approach and unique antibiotic management.