Sepsis Management in Southeast Asia: A Review and Clinical Experience

Abstract

Sepsis is a life-threatening condition that causes a global health burden associated with high mortality and morbidity. Often life-threatening, sepsis can be caused by bacteria, viruses, parasites or fungi. Sepsis management primarily focuses on source control and early broad-spectrum antibiotics, plus organ function support. Comprehensive changes in the way we manage sepsis patients include early identification, infective focus identification and immediate treatment with antimicrobial therapy, appropriate supportive care and hemodynamic optimization. Despite all efforts of clinical and experimental research over thirty years, the capacity to positively influence the outcome of the disease remains limited. This can be due to limited studies available on sepsis in developing countries, especially in Southeast Asia. This review summarizes the progress made in the diagnosis and time associated with sepsis, colistin resistance and chloramphenicol boon, antibiotic abuse, resource constraints and association of sepsis with COVID-19 in Southeast Asia. A personalized approach and innovative therapeutic alternatives such as CytoSorb^® are highlighted as potential options for the treatment of patients with sepsis in Southeast Asia.

Keywords: COVID-19; colistin resistance and chloramphenicol boon; cytosorb; sepsis; septic shock.

Figure 1

Blue: Mortality rate due to sepsis; Yellow: Prevalence of ICU units in various Southeast Asian countries.

Figure 2

Emergence of colistin resistant gene and the cases associated with them.

Figure 3

Various available extracorporeal therapies.