MANAGEMENT OF SEPSIS IN ADULTS: A LITERATURE REVIEW

• DOI: https://doi.org/10.22533/at.ed.1595322621019

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• Keywords: -

• Abstract:

  Introduction: Sepsis is a serious clinical condition associated with high morbidity and mortality, whose often delayed diagnosis contributes to the progression of organ dysfunction. It results from a dysregulated inflammatory response of the host to infection and can progress to septic shock, characterized by persistent hypotension, tissue hypoperfusion, and cellular hypoxia. Prognostic tools such as the q-SOFA score are useful in stratifying the risk of in-hospital mortality. The management of sepsis is based on early recognition and rapid administration of antibiotics, since delays in antibiotic therapy are associated with a significant increase in mortality, reinforcing the importance of immediate intervention.
  Method: This study is a narrative review that analyzed the literature on the management of sepsis in adult patients. Articles were selected from the PubMed databases using the keywords "management," "sepsis," and "adult patients." Inclusion criteria covered articles in English and Portuguese published in the last year. Studies with unclear methodology or irrelevant to the topic were excluded. A total of 5 articles were selected and analyzed. Results and Discussion: The analyzed literature consistently demonstrates that the treatment of sepsis should be structured in sequential and interdependent stages, including early recognition, rapid activation of response systems, initial resuscitation, timely antibiotic therapy, hemodynamic stabilization, continuous care, and post-sepsis rehabilitation. The results indicate that improved clinical outcomes depend on the integration of well-established protocols, multidisciplinary teams, and prepared health systems, reinforcing the time-dependent nature of sepsis. Recent evidence suggests that the order of initial antibiotic administration influences hospital mortality, with early infusion of β-lactams before vancomycin associated with lower mortality, even after adjusting for disease severity. In addition, studies have shown that the duration of antibiotic therapy guided by biomarkers, especially procalcitonin, reduces the time of antimicrobial use without
   
  increased mortality, therapeutic failure, or infectious recurrence, contributing to the rational use of antibiotics. With regard to microbiological investigation, more severe clinical signs were associated with a higher probability of positive blood cultures, while indiscriminate collection in low-risk patients had low diagnostic value and a higher contamination rate. Finally, the use of vasopressors via peripheral venous access in the early stages of sepsis proved to be safe and effective when performed under appropriate protocols, allowing for faster initiation of hemodynamic support and a low incidence of local complications.
  Conclusion: Although severe, sepsis has better outcomes when managed early and according to protocol. Timely recognition, adequate diagnostic investigation, and correct antibiotic therapy—considering not only the timing but also the sequence of administration—are crucial for therapeutic success.