UPMC physician: Providers need a 'bolder' approach to win the battle against sepsis

Despite the high number of sepsis deaths in hospitals each year, current approaches to battling it aren't working — and providers need to develop more innovative ways to tackle the deadly infection, Derek Angus, MD, professor and chair of critical care medicine at the University of Pittsburgh School of Medicine, writes in a STAT op-ed.

"If we can strive to fight a new scourge like opioids, we should be able to do the same for a much older killer," Dr. Angus argues.

Although Medicare and state governments are leading initiatives to ensure hospitals can rapidly screen patients suspected of having sepsis and begin treating those diagnosed with the infection, these efforts aren't enough to "solve sepsis," Dr. Angus argues.

"The problem with these initiatives is that they begin and end with trying to make sure every patient can receive the best version of today's care. It's a noble and worthy goal, but it won't on its own 'solve sepsis,'" Dr. Angus writes. "If every patient with sepsis received the ideal current care, the mortality rate would drop a little, but 200,000 Americans would still die from it each year."

Despite ongoing issues with funds and care practices surrounding sepsis, Dr. Angus outlined a "bolder plan" to begin tackling the infection in three steps:

1. Develop innovative methods to identify sepsis earlier and more accurately. Potential inventions to better identify sepsis include smart wearable technologies that detect physiological stress and decompensation as well as molecular biology tests that can find invading pathogens and the body's immune response to them. "Yet many of the companies developing these tools have neither the funds nor the wherewithal to test effectively and efficiently what can really help at the bedside," Dr. Angus writes.

2. Establish stronger treatment strategies for patient care as opposed to making newer antibiotics. "While there are potential therapies that might work, testing them in clinical trials is very costly," Dr. Angus writes. "In addition, there aren't really any incentives to entice the companies developing these drugs to work with those developing diagnostic technologies."

3. Find better ways to treat and care for sepsis survivors. "Solving sepsis is not simply about avoiding death," Dr. Angus says. To better care for sepsis survivors, UPMC, Nashville, Tenn.-based Vanderbilt University Medical Center and several other hospitals created post-intensive-care recovery clinics. But more work needs to be done, Dr. Angus says, since most patients live far from focused support and few research programs testing ways to improve long-term outcomes from sepsis. "The NIH should be working with academic researchers, clinicians, and the private sector to do more," Dr. Angus argues.

"Sepsis is the most expensive and deadliest condition we are battling in our hospitals," Dr. Angus concludes. "But when did you last see headlines trumpeting a blockbuster new sepsis drug? You haven't — and you won't — until we make a serious commitment to fight the oldest disease of all."

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