ReviewVirulence2014
An alternate pathophysiologic paradigm of sepsis and septic shock: implications for optimizing antimicrobial therapy.
Review in Virulence, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Guideline
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Source control within 12 h attenuates lung injury and systemic bacterial burden in a rat model of polymicrobial abdominal sepsis (cecal ligation and puncture).Intensive care medicine experimental · 2026Article
- Association of oXirisJournal of personalized medicine · 2025Article
- Fragment end motif analysis to distinguish pathogens from contaminants in enriched plasma microbial DNA.medRxiv : the preprint server for health sciences · 2025Article
- Antimicrobial stewardship interventions reduce the time to the first antibiotic administration in septic patients in ICUs: regional multicenter study in 7 Latin American high-complexity hospitals.Antimicrobial agents and chemotherapy · 2025Article
- A Quantitative Examination and Comparison of the Ability of Australian Gentamicin Dosing Guidelines to Achieve Target Therapeutic Concentrations in Neonates.Antibiotics (Basel, Switzerland) · 2025Article
- Prompt antimicrobial therapy and source control on survival and defervescence of adults with bacteraemia in the emergency department: the faster, the better.Critical care (London, England) · 2024Article
- Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of personalized medicine · 2024Review
- Article
- Sepsis Stewardship: The Puzzle of Antibiotic Therapy in the Context of Individualization of Decision Making.Journal of personalized medicine · 2024Review
- Application of metagenomic next-generation sequencing in the diagnosis of infectious diseases.Frontiers in cellular and infection microbiology · 2024Review
- β-Lactam Dosing in Critical Patients: A Narrative Review of Optimal Efficacy and the Prevention of Resistance and Toxicity.Antibiotics (Basel, Switzerland) · 2022Review
- Pharmacodynamics of Piperacillin-Tazobactam/Amikacin Combination versus Meropenem against Extended-Spectrum β-Lactamase-Producing Escherichia coli in a Hollow Fiber Infection Model.Antimicrobial agents and chemotherapy · 2022Article
- Roles of neutrophil reactive oxygen species (ROS) generation in organ function impairment in sepsis.Journal of Zhejiang University. Science. B · 2022Review
- Bedside determination of microcirculatory oxygen delivery and uptake: a prospective observational clinical study for proof of principle.Scientific reports · 2021Article
- Analysis of Prognostic Risk Factors of Bloodstream Infections in Beijing Communities: A Retrospective Study from 2015 to 2019.Mediterranean journal of hematology and infectious diseases · 2021Article
- Identification of Key Immune-Related Genes in the Progression of Septic Shock.Frontiers in genetics · 2021Article
- Effects of viral infection and microbial diversity on patients with sepsis: A retrospective study based on metagenomic next-generation sequencing.World journal of emergency medicine · 2021Article
- The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis.Journal of cellular and molecular medicine · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The advent of modern antimicrobial therapy following the discovery of penicillin during the 1940s yielded remarkable improvements in case fatality rate of serious infections including septic shock. Since then, pathogens have continuously evolved under selective antimicrobial pressure resulting in a lack of significant improvement in clinical effectiveness in the antimicrobial therapy of septic shock despite ever more broad-spectrum and potent drugs. In addition, although substantial effort and money has been expended on the development novel non-antimicrobial therapies of sepsis in the past 30 years, clinical progress in this regard has been limited. This review explores the possibility that the current pathophysiologic paradigm of septic shock fails to appropriately consider the primacy of the microbial burden of infection as the primary driver of septic organ dysfunction. An alternate paradigm is offered that suggests that has substantial implications for optimizing antimicrobial therapy in septic shock. This model of disease progression suggests the key to significant improvement in the outcome of septic shock may lie, in great part, with improvements in delivery of existing antimicrobials and other anti-infectious strategies. Recognition of the role of delays in administration of antimicrobial therapy in the poor outcomes of septic shock is central to this effort. However, therapeutic strategies that improve the degree of antimicrobial cidality likely also have a crucial role.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.