The changing pattern of bacterial sepsis since the introduction of antibiotic therapy.
During the six-year period, 1968-1973, sepsis developed in 1 of every 80 patients admitted to the Presbyterian Hospital, New York. In 1 of 133 patients the sepsis was due to Gram-positive organisms, and in 1 of 188 patients to Gram-negative organisms. The mortality rate for Gram-positive cases was 4.4 percent, for Gram-negative cases 19.1 percent, and for urologic cases 15.3 percent (versus 56.25 percent in 1959-1964). Data are presented on the relative incidences of involved pathogens in 1740 cases of Gram-positive sepsis /78 deaths), and in 1236 cases of Gram-negative sepsis (205 deaths). The lowering of the sepsis mortality rate has been the result of preventative measures, early diagnosis, and vigorous treatment. Treatment includes the correction of acidosis and anoxia, early administration of bactericidal antibiotics, and restoration of the microcirculation by administration of corticosteroids, beta-adrenergic drugs, and appropriate diuretics.
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