Pediatric Sepsis and Septic Shock

Pediatrik Sepsiste Mikrobiyoloji ve Antibiyotik Tedavisi
Microbiology and Antibiotic Treatment in Pediatric Sepsis
Elif BÖNCÜOĞLUa, Elif KIYMETa, İlker DEVRİMb
aSağlık Bilimleri Üniversitesi İzmir Dr. Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Çocuk Enfeksiyon Hastalıkları Kliniği, İzmir, Türkiye
bSağlık Bilimleri Üniversitesi İzmir Dr. Behçet Uz Çocuk Hastalıkları ve Cerrahisi Sağlık Uygulama ve Araştırma Merkezi, Çocuk Enfeksiyon Hastalıkları Kliniği, İzmir, Türkiye
Böncüoğlu E, Kıymet E, Devrim İ. Pediatrik sepsiste mikrobiyoloji ve antibiyotik tedavisi. Ağın H, editör. Pediatrik Sepsis ve Septik Şok. 1. Baskı. Ankara: Türkiye Klinikleri; 2022. p.74-8.
Article Language: TR
ÖZET
Sepsis, şüpheli veya kanıtlanmış enfeksiyon sonucu olarak sistemik inflamatuar yanıt bulgularının varlığı olarak tanımlanır. Düşük ve orta gelir düzeyli ülkeler başta olmak üzere tüm dünyada önde gelen morbidite ve mortalite nedenlerinden biridir. Sepsise bağlı morbidite ve mortalitenin önlenmesinde doğru zamanda olası etkenleri kapsayacak uygun tedavinin başlanması kritik öneme sahiptir. Septik şok tablosunda olan pediatrik hastalarda, sepsisin tanınmasında sonraki bir saat içinde mümkün olan en kısa sürede geniş spektrumlu ampirik antibiyotik tedavisi başlanması önerilir. Sepsis tedavisinde ampirik antibiyotik rejimi seçerken hastanın yaşı, bağışıklık durumu, yakın zamanda hastane ve antibiyotik maruziyeti dikkate alınır. Etken tanımlandıktan sonra antibiyotik duyarlılık sonuçları ve hastanın klinik durumu dikkate alınarak her merkezin kendi belirlediği risk grup tanımlamaları doğrultusunda antibiyotik azaltma veya kesme planı olmalıdır.

Anahtar Kelimeler: Sepsis; septik şok; antibakteriyel ajanlar
ABSTRACT
Sepsis is defined as the presence of signs of a systemic inflammatory response as a result of suspected or proven infection. It is one of the leading causes of morbidity and mortality all over the world, especially in low and middle-income countries. Initiation of appropriate treatment to cover possible pathogens at the right time is critical for the prevention of morbidity and mortality due to sepsis. In pediatric patients with septic shock, it is recommended to initiate broad-spectrum empirical antibiotic therapy as soon as possible within one hour of diagnosis of sepsis. Age, immune status, recent hospital stay history, and antibiotic exposure of the patient are taken into consideration when choosing an empirical antibiotic regimen for the treatment of sepsis. After the causative agent is identified, each center should have an antibiotic de-escalation or discontinuation plan in line with its own risk group definitions, considering the antibiotic sensitivity results and the clinical condition of the patient.

Keywords: Sepsis; septic shock; anti-bacterial agents

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30.03.2014

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