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Barriers to the effective treatment of sepsis: antimicrobial agents, sepsis definitions, and host‐directed therapies
Author(s) -
Lyle Ngan H.,
Pena Olga M.,
Boyd John H.,
Hancock Robert E. W.
Publication year - 2014
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.12444
Subject(s) - sepsis , host response , intensive care medicine , antimicrobial , medicine , host (biology) , clinical trial , immune system , immunology , disease , biology , microbiology and biotechnology , ecology
Sepsis is a complex clinical syndrome involving both infection and a deleterious host immune response. Antimicrobial agents are key elements of sepsis treatment, yet despite great strides in antimicrobial development in the last decades, sepsis continues to be associated with unacceptably high mortality (∼30%). This is the result, on one hand, of the rise of antimicrobial resistant organisms and, on the other hand, of the dearth of effective host‐directed immune therapies. A major obstacle to the development of good host‐directed therapies is the lack of understanding of the host immune response. The problem is exacerbated by poor nonspecific clinical definitions of disease. Poor definitions have had a profound impact on sepsis research, from epidemiologic studies to the failed clinical trials of host‐directed therapies. Therefore, better definitions must be developed to enable advancement in the field.