Sepsis (Septicemia)

Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by HYPOTENSION despite adequate fluid infusion, it is called SEPTIC SHOCK.

Also Known As:

Networked: 32696 relevant articles (2056 outcomes, 4221 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Infection
2.	Septic Shock (Toxic Shock Syndrome)
3.	Wounds and Injuries (Trauma)
4.	Pneumonia (Pneumonitis)
5.	Burns

Experts

1.	Vincent, Jean-Louis: 115 articles (11/2015 - 01/2002)
2.	Wang, Ping: 87 articles (01/2016 - 01/2002)
3.	van der Poll, Tom: 84 articles (12/2015 - 06/2003)
4.	Dal-Pizzol, Felipe: 64 articles (05/2015 - 02/2003)
5.	Bellomo, Rinaldo: 62 articles (10/2015 - 01/2002)
6.	Ward, Peter A: 62 articles (05/2015 - 05/2002)
7.	Reinhart, Konrad: 57 articles (07/2015 - 02/2002)
8.	Opal, Steven M: 55 articles (12/2015 - 05/2002)
9.	Tracey, Kevin J: 53 articles (02/2015 - 01/2002)
10.	Giamarellos-Bourboulis, Evangelos J: 52 articles (01/2016 - 09/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Sepsis:

1.	Anti-Bacterial Agents (Antibiotics)IBA 06/01/1984 - "A number of appropriate antibiotics and antibiotic combinations are available for intraabdominal sepsis, but most data still favor combinations of an antiaerobic drug, most often an aminoglycoside, and an antianaerobic drug--and possibly a third agent effective against enterococci." 12/01/1994 - "Overall neonatal sepsis incidence changed very little, but there was a marked decrease in very early onset sepsis in 1988 to 1992 especially in very low birth weight (< 1500 g) infants, possibly attributable to increased use of prenatal antibiotics. " 08/01/2015 - "Conventional antibiotics exhibit immunomodulatory properties beneficial in the treatment of sepsis. " 11/01/2012 - "Because sepsis occurred significantly more often in the placebo arm versus the active-treatment arm, the role of antibiotics in causing remission cannot be discounted (6.8% vs 0%; P < .05). " 10/01/2008 - "Two patients developed sepsis with good outcome with intravenous antibiotics treatment. "
2.	Protein CIBA 09/01/2008 - "Since the initial Protein C Worldwide Evaluation in Severe Sepsis trial demonstrating efficacy of aPC therapy to reduce mortality of severe sepsis, follow-up studies have failed to resolve concerns about the low overall risk-to-benefit ratio of this therapy and suggest that it might only be effective in severely ill patients with the most aggravated forms of coagulopathy. " 05/01/2005 - "Anticoagulant therapy with activated protein C has been shown to improve survival in sepsis, the most common risk factor for the development of ALI/ARDS, and is now being studied in ALI/ARDS. " 10/14/2005 - "The studies, PROWESS and ADDRESS, enrolled a total of 4329 patients with risk ratio (RR) and 95% confidence interval (CI) data for effect on 28-day mortality relative to control treatment of 0.92 (0.83-1.02) suggesting that recombinant human activated protein C is not beneficial in severe sepsis. " 01/01/2014 - "Activated protein C (aPC) plays a pivotal role in modulating a severe inflammatory response and is thought to be beneficial for patients with sepsis. " 10/01/2012 - "Microparticles may in fact be beneficial in early sepsis, given that activated protein C bound to endothelium-derived microparticles retains anticoagulant activity, and increased circulating microparticles are protective against vascular hyporeactivity. "
3.	drotrecogin alfa activated (Xigris)FDA Link 01/01/2002 - "850 patients with severe sepsis treated with intravenous drotrecogin alfa (activated) 24 microg/kg/h for 96 hours had a significantly greater reduction in 28-day all-cause mortality (24.7%) than 840 placebo recipients (30.8%) in a randomised, double-blind, placebo-controlled study. " 08/01/2005 - "These cases of severe sepsis and immunosuppression indicate a high therapeutic efficacy of drotrecogin alfa (activated). " 01/01/2003 - "Drotrecogin alfa (activated) has anti-inflammatory, antithrombotic, profibrinolytic, and other properties that may explain the beneficial results seen in both animal models and humans with severe sepsis. " 01/01/2002 - "While a recent Phase III study of rhAPC suggests a survival benefit in patients with sepsis, major concerns about this trial include the manner in which the study was conducted, the potential toxicity of rhAPC and the questionable efficacy of this agent in patients with low mortality risk. " 03/01/2011 - "For example, drotrecogin alfa (activated) was shown to be effective at reducing mortality in a clinical trial with a heterogeneous patient population,(28) although even here positive results were restricted to patients who had severe sepsis, highlighting the importance of being able to better characterize patients. "
4.	Tumor Necrosis Factor-alpha (Tumor Necrosis Factor)IBA 05/01/1994 - "Both anti-interleukin-1 and anti-tumor necrosis factor (TNF) therapies have been beneficial in some animal models of sepsis but did not clearly improve survival in initial human trials, and one anti-TNF therapy actually produced harm. " 05/01/2006 - "Pretreatment with AV-ext significantly decreased the levels of tumor necrosis factor-alpha (TNF-alpha) in serum and liver and lung tissues, and improved the survival of mice with experimental sepsis. " 11/01/1999 - "With this three pronged rationale, the authors were able to convince Centocor, Inc, which had developed a chimaeric anti-TNFalpha antibody for use in sepsis, to work with them to test the concept that TNFalpha blockade would be beneficial in RA. " 09/01/1996 - "These data demonstrate that treatment with PTXF may ameliorate some of the deleterious hemodynamic manifestations of GBS sepsis and result in improved survival in a young animal model without significantly modifying plasma TNF-alpha levels." 01/01/1990 - "The patients with sepsis showed significantly greater total TNF alpha levels (secreted in combination with cell-associated) 3 days before septic episodes, as compared with normal controls (32.38 to 2231.76 ng/10(6) monocytes per milliliter, median = 121.03 ng/10(6) monocytes per milliliter; normal control: 0.00 to 18.20 ng/10(6) monocytes per milliliter, median = 5.93 ng/10(6) monocytes per milliliter). "
5.	CytokinesIBA 10/17/1998 - "Ad-hoc measurement of these cytokines could allow earlier initiation of antibiotic therapy with corresponding improvement in outcome in very-low-birthweight infants with sepsis." 03/01/1998 - "The hypothesis that neutralization of endotoxin and pro-inflammatory cytokines is beneficial in sepsis was seriously challenged by the results of recent clinical and experimental studies. " 12/01/2011 - "TLR2(-/-) mice may produce relatively low levels of proinflammatory cytokines following pneumococcal challenge, thus hindering the clearance of bacteria from the middle ear and leading to sepsis and high mortality rate. " 07/01/2009 - "In summary, TLR2(-/-) mice may produce relatively low levels of proinflammatory cytokines following pneumococcal challenge, thus hindering the clearance of bacteria from the middle ear and leading to sepsis and a high mortality rate. " 08/01/2006 - "The techniques to remove cytokines, including high-volume haemofiltration, haemodialysis using high-cut-off haemofilters, and absorptive techniques, lead to some improvement in outcome but are still insufficient to reverse the complicated biological dysregulation resulting from ARF associated with sepsis. "
6.	Dacarbazine (DIC)FDA LinkGeneric 01/01/2014 - "Our results suggest that TM-α is most effective for treating patients with sepsis-induced DIC when administered within the first 3 days after diagnosis." 01/01/1998 - "If DIC could be identified earlier and AT concentrate could then be given earlier in the sepsis continuum, study results for the use of AT concentrate in humans might reveal a statistically significant difference versus placebo, and the efficacy of AT concentrate for this syndrome is more likely to be proved. " 07/01/2014 - "In sepsis-related DIC, the basis for anticoagulant therapy comes from the mounting evidence for the anti-inflammatory effects which these agents possess and can prove beneficial in septic situations. " 01/01/1998 - "Studies already indicate that the therapeutic use of antithrombin (AT) concentrate may produce a more positive outcome for sepsis-associated DIC. " 05/01/2002 - "Several studies have shown that administration of ATIII in patients with sepsis related DIC is effective in shortening the duration of DIC. "
7.	procalcitoninIBA 10/01/2002 - "Amino-prohormone procalcitonin-reactive antiserum administration resulted in a significant improvement or a beneficial trend in a majority of the measured physiologic and metabolic derangements induced by sepsis. " 11/01/2007 - "Ultrasensitive assays for procalcitonin, capable of measuring low levels in healthy individuals, may help to identify even 'subclinical' inflammatory states before the development of clinically evident sepsis. " 02/01/2001 - "The amount of procalcitonin eliminated in the urine and the plasma disappearance rate of procalcitonin were evaluated in patients with normal and impaired renal function, because patients with sepsis are a main target group for procalcitonin measurement, and these patients often develop renal dysfunction. " 11/01/2008 - "Using procalcitonin to diagnose sepsis and the potential for improved antibiotic stewardship." 07/01/2015 - "Early-Onset Neonatal Sepsis: Still Room for Improvement in Procalcitonin Diagnostic Accuracy Studies."
8.	AntibodiesIBA 01/01/2002 - "Passive immunization with anti-HMGB1 antibodies confers significant protection against lethality induced by LPS administration and sepsis caused by cecal perforation in mice. " 10/01/1999 - "Transfer of SEA-specific antibodies to naive mice resulted in good protection against death in staphylococcal sepsis. " 09/01/2015 - "We found that our anti-Sema3A antibodies were effective for improving the survival rate in lipopolysaccharide-induced sepsis in mice. " 10/01/1999 - "While initial clinical studies with the passive administration of anti-endotoxin core-glycolipid (CGL) antibodies for the treatment and prophylaxis of sepsis showed promising results, subsequent studies failed to show a consistent benefit. " 03/01/2001 - "Protective effects of anti-C5a peptide antibodies in experimental sepsis."
9.	Biological Markers (Surrogate Marker)IBA 09/01/2014 - "Future research studies to assess reliability of these biomarkers should be (1) adequately powered for sample size and (2) use the gold-standard definition of blood-culture proven pathogen-specific sepsis. " 02/01/2014 - "Novel biomarkers with high sensitivity and specificity may be helpful for early diagnosis of sepsis and for improvement of patient outcomes through the development of new therapies. " 01/01/2013 - "Combined with innovative approaches to treatment that target the immunosuppressive phase, these biomarkers may help to reduce the mortality rate associated with severe sepsis which, despite advances in supportive measures, remains high." 09/01/2012 - "PCT as an early independent biomarker for sepsis is superior to immune inflammatory biomarkers (CRP, IL-6, SAA), also is better than the combination of these four biomarkers for economic effect." 08/01/2012 - "A combination of different biomarkers improves the diagnostic accuracy and is more effective in the prognosis of sepsis in rats. "
10.	Gentamicins (Gentamicin)FDA LinkGeneric 09/01/2005 - "Because gentamicin improved hemodynamic variables and reduced the fluid requirement in this ovine model, we believe that this modified sepsis model might provide a clinically relevant and useful new approach for future studies focusing on hemodynamic variables and outcome." 06/01/1997 - "The protocol proved simple and effective with a low incidence of gentamicin-associated nephrotoxicity (7%) and no sepsis-related deaths." 05/01/2014 - "Gentamicin concentrations and clinical data including the Reported Edmonton Frail Scale score were pooled from two prospective observational inpatient studies, one on prophylactic gentamicin for urologic surgery and one on therapeutic gentamicin for the empiric treatment of sepsis. " 10/01/2009 - "The study was conducted to evaluate the pharmacokinetics of gentamicin for the treatment of neonatal sepsis in predetermined doses at 24- or 48-hour intervals, according to weight category, and to develop a simplified protocol for use in peripheral healthcare settings in developing countries. " 06/01/2007 - "The purpose of this study was to determine safe, effective, simplified dosing regimens of gentamicin for treatment of neonatal sepsis in developing countries. "

Therapies and Procedures

1.	Ligation 11/01/2013 - "As known, sepsis induced by surgery of cecal ligation and puncture (CLP) is widely accepted as the gold standard animal model, but the inconsistency of outcomes is the most obvious problem. " 06/15/2014 - "Previous studies have demonstrated that the SDF-1α analog CTCE-0214 (CTCE) is beneficial in polymicrobial sepsis induced by cecal ligation and puncture (CLP) in mice. " 05/01/2014 - "Using lckCre-GR(fl/fl) mice in which thymocytes lack cecal ligation and puncture-induced thymocyte apoptosis, we showed that lckCre-GR(fl/fl) mice were significantly more susceptible to cecal ligation and puncture-induced septic death than GR(fl/fl) control mice, suggesting that glucocorticoid-induced thymocyte apoptosis is required for protection against sepsis. " 01/01/2014 - "The adhesive was also effective in a cecal ligation and puncture model, preventing sepsis and significantly improving survival. " 11/01/2012 - "We recently reported that adoptive transfer of bone marrow CD34(+) cells into mice after sepsis induction by cecal ligation and puncture significantly improves late-sepsis survival by enhancing bacterial clearance through improved neutrophil and macrophage phagocytosis. "
2.	Catheters 02/01/1994 - "NSTs dramatically reduced the incidence of catheter-related complications, especially sepsis, by developing central venous catheter insertion and care guidelines. " 12/01/1982 - "Only four cases (7%) of catheter-associated sepsis occurred, a significant reduction (p = 0.008) in this serious problem compared to the previous large catheter study. " 01/01/1998 - "The differential positivity time was significantly greater for patients with catheter-related sepsis (P < 10(-4)). " 07/01/1993 - "A significantly greater rate of Gram-negative sepsis was noted in the IV cannula group (6.6%) compared with direct venipuncture with needle change (1.1%) and no needle change (4.2%, P < .01). " 01/01/1984 - "A significant reduction in catheter sepsis was observed and was attributable to the establishment of an NSS, specifically, a nurse specialist and protocols for catheter insertion and care."
3.	Resuscitation 01/01/2013 - "There is evidence that suggests that early fluid resuscitation is beneficial in the treatment of sepsis. " 10/01/2008 - "This meta-analysis found that applying an early quantitative resuscitation strategy to patients with sepsis imparts a significant reduction in mortality." 10/01/2004 - "Volume resuscitation is clinically beneficial in patients with sepsis, but few data exist concerning the effects of fluid administration on early events in the inflammatory process. " 01/01/1992 - "In the light of our report, survival of Low Birthweight infants is a strong reflection of that of VLBW infants and survival of this category of babies could be improved by instituting general measures such as those aimed at reducing the incidence of LBW in the environment and by specific measures like carrying out prompt and effective resuscitation of the asphyxiated neonate and preventing sepsis. " 01/01/2012 - "The overall compliance to 6-hour sepsis resuscitation bundle elements was associated with improved survival [odds ratio (OR), 5.8 (95% CI, 2.2-15.1; P < 0.001)]. "
4.	Drug Therapy (Chemotherapy) 06/01/1995 - "Although complete remission was sustained with courses of chemotherapy for 4 months, relapse occurred and the patient died of septicemia on August 29, 1994 after induction failure. " 03/01/1990 - "A second complete remission was achieved in 5 of these patients, while 1 died of chemotherapy-induced sepsis. " 01/01/1982 - "Necessary dental treatment prior to chemotherapy was accompanied by a significant reduction in the rate of septicemia. " 01/01/1991 - "The polymicrobial nature of intra-abdominal sepsis mandates antimicrobial chemotherapy effective against a broad range of organisms. " 09/01/2014 - "No drug therapy has demonstrated improved clinical outcomes in the treatment of sepsis. "
5.	Transplants (Transplant) 05/01/1995 - "Complete excision of infected graft material results in a significant reduction in the incidence of recurrent sepsis." 08/13/2014 - "Lymph node fibroblastic reticular cell transplants show robust therapeutic efficacy in high-mortality murine sepsis." 11/01/2005 - "This study was developed to evaluated the effects of spleen transplants in the protection against abdominal sepsis in young and old Wistar rats. " 05/01/2008 - "They were often confused with non microbial sepsis and responded well to immunosuppressive treatment, even though the fluid surrounding the graft sometimes fistulised to the skin. " 01/01/2008 - "aureus counts in the infected vascular grafts, prevented sepsis, and drastically improved survival rates. "