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Sepsis breakthrough: ‘Thousands of lives could be saved’

British MP Craig Mackinlay reveals his sepsis horror

Source: Channel 5 News

Eleven million people die of sepsis, globally, every year. That’s one in five of all deaths. Eight thousand of them occur in Australia.

The numbers are as bleak as the physical reality of the disease.

Sepsis occurs when, instead of fighting an infection, the body’s immune system malfunctions. It lets rip with inflammation that damages tissue and organs.

It can take as little as 12 hours from the earliest signs of infection to organ failure and death.

Earlier this year, British MP Craig Mackinlay revealed his own horrifying battle with the disease. He spent 16 days in an induced coma, and was given only a 5 per cent chance of survival after falling ill with sepsis last September.

“It is not a day I ever wanted. I would rather be sitting on the backbenches whole and complete,” Mackinlay told the House of Commons after returning on artificial feet and with artificial hands because the disease cost him all four limbs.

“I have been through eight months of hell, had sepsis, lost all my limbs. But I am back.”

Now Australian researchers have found that changing the way that antibiotics are intravenously given to adult patients with sepsis will save thousands of lives a year globally.

Previous laboratory studies had indicated that delivering antibiotic doses as a continuous infusion would more successfully “maintain the concentration of the antibiotic in a patient’s blood and tissue, and kill bacteria at a greater rate”.

But laboratory studies need to be rigorously tested in a clinical setting, before a new protocol can be adopted by hospitals around the world.

Scientists from University of Queensland and the George Institute for Global Health have done just that.

The clinical trial

A clinical trial of more than 7000 patients – along with a systematic review – have shown that intravenously administering commonly used penicillin-like antibiotics via continuous infusion cures infections and saves lives.

Professor Jason Roberts is director of the University of Queensland’s Centre for Clinical Research.

He said: “This simple intervention uses commonly available antibiotics, so even small hospitals in third-world countries can implement the dosing change almost as easily as well-resourced hospitals in developed countries.”

If this new protocol was adopted globally, he said, “it could potentially save hundreds of thousands of lives”.

In the trial, he said, some patients were given antibiotics in the usual way, which is three or four different doses over the course of the day.

Other patients were given that same dose but as a continuous infusion over a number of days.

Typically treatment is between three to seven days, Professor Roberts said. Depending on how severe the infection is, treatment can take longer.

The study concluded: “Among adults in the intensive care unit who had sepsis or septic shock, the use of prolonged β-lactam antibiotic infusions was associated with a reduced risk of 90-day mortality compared with intermittent infusions.

“The current evidence presents a high degree of certainty for clinicians to consider prolonged infusions as a standard of care in the management of sepsis and septic shock.”

What about the children?

According to the World Health Organisation, almost half of the 49 million cases of sepsis each year occur among children.

This results in 2.9 million deaths, most of which could be prevented through early diagnosis and appropriate clinical management.

These deaths are often a consequence of diarrhoeal diseases or lower respiratory infections.

If this new approach to antibiotics could save a multitude of adults, what about the children? The study findings can’t be translated to children.

A child-focused clinical study is required. And clinical studies, when done to a persuasive standard, don’t come cheap.

Professor Roberts and his colleagues have worked with the Queensland Children’s Hospital to develop a funding application and submitted that to one of the Australian funding agencies.

“It makes a lot of sense to demonstrate in children whether or not  this is beneficial,” he said.

If the application fails, well, let’s hope that a wealthy benefactor might raise his or her arm.

Read more about sepsis here.

Topics: sepsis
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