Annals in the Clinic
Sepsis is the leading cause of death worldwide. Mortality has improved in the past few decades but remains high, and survivors frequently have long-term complications. Initial diagnostic evaluation focuses on risk stratification and source and pathogen identification. Treatment includes intravenous fluids, vasopressors, steroids if shock is present, antimicrobial therapy targeting the most likely source of infection, and source control. Patients with shock or high-risk organ failure syndromes should be admitted early to an intensive care unit. After initial antimicrobials and resuscitation, care should focus on antimicrobial deescalation, volume management, and high-quality supportive care. Shared decision making about goals of care and transitions is important to support survivors after discharge.
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Annals in the Clinic
Annals In the Clinic is a monthly feature in Annals of Internal Medicine introduced in January 2007 that focuses on practical management of patients with common clinical conditions. It offers evidence-based answers to frequently asked questions about screening, prevention, diagnosis, therapy, and patient education and provides physicians with tools to improve the quality of care.
