How Effective are Antibiotics for Sepsis?

The effectiveness of antibiotics for sepsis depends on many factors. Treatment is most successful in healthy patients who receive prompt critical care and who do not develop septic shock. Inflammation and subsequent oxygen deprivation are the major causes of organ damage during sepsis, and these adversely influence the success of antibiotic treatment. If the infection is caused by an antibiotic resistant bacteria, complications are more likely. Neonatal sepsis is especially dangerous and requires a delicate balance of antimicrobial and other treatments to prevent death or brain damage.

Sepsis occurs when a systemic bacterial infection causes the immune system to respond with inflammation. It is treated by hospital care that includes fluid support, antimicrobial, and anti-inflammatory agents. Antibiotics are the bedrock of treatment since fighting the spread of the bacteria and the effects of their toxins is essential to patient survival. Successful use of antibiotics for sepsis depends on the particular microorganism involved and on the strength of the patient's immune system, among other factors. If many tissues become inflamed, death can result when blood clotting cuts off oxygen supplies and causes multiple organ failures, a condition called septic shock.

The effectiveness of antibiotics for sepsis is highest when patients are medicated quickly during infection and haven't had prolonged hypotension caused by septic shock. Early treatment reduces the patient's chance of going into shock from the strength of the immune response. This in turn decreases the risk of organ damage and gives the antibiotics enough time to destroy or lower the bacterial blood count. The overall quality of hospital critical care is important in minimizing the effects of inflammation or toxins secreted by the bacteria and influences the effectiveness of treatment. Patients who have had heart valve surgery tend to have a high risk of complications if they become septic.

Hospital-acquired infections are caused by bacteria that have grown resistant to many of the normally prescribed antibiotics. Even with early and appropriate drug selection, sepsis from resistant bacterial strains has a higher mortality rate. Staphylococcus aureus, for instance, is resistant to penicillin and similar classes of drugs. Sometimes cephalosporin antibiotics are quite successful in treating hospital-acquired sepsis, but some microorganisms have grown resistant even to these. Aminoglycosides are effective in reducing patient deaths from the resistant strains of bacteria, but these medications sometimes cause kidney damage.

Antibiotic treatment for neonatal sepsis is quite challenging. Neonatal sepsis has a mortality rate as high as 50% in untreated cases, sometimes due to inflammation around the brain as a consequence of bacterial meningitis. Intravenous use of antibiotics for neonatal sepsis is fairly effective if it occurs early on. The choice of antibiotics for sepsis of this kind varies with the bacterial type, the mother's history, and the rate of infection in the particular intensive care unit where the infant is being treated.