Review of sepsis in Pakistan: how far have we come?

Abstract

Pakistan is a low-middle-income country (LMIC) with a high burden of sepsis, yet there is a profound dearth of data regarding sepsis with no comprehensive review. In Pakistan, access to competent healthcare services is delayed and in places, often not available. Patients may present with sepsis after common community-acquired infections; the commonest sources of sepsis are the respiratory tract followed by the urinary tract. Gram-negative organisms are responsible for a large majority of cases of sepsis. Unfortunately, compliance with sepsis guidelines remains poor, and sepsis-related statistics do not seem to be improving significantly. Adult sepsis presents a significant burden on healthcare services, particularly in LMICs, and is a leading cause of morbidity and mortality. Many factors which affect outcomes and cost of care are amenable to prompt interventions. Consequently, there is a dire need to make concentrated efforts in implementing simple, cost-effective, and context-specific guidelines and monitoring strategies regarding the diagnosis and management of sepsis. The collection and analysis of information on sepsis in Pakistan hence remains imperative, in order to prospectively assess the effects of guideline compliance on outcomes and to formulate and refine new schemata to address emerging problems.

Keywords: Antibiotic; Mortality; Pakistan; Resistance; Sepsis.

Figure 1

Causative factors and potential solutions for sepsis disease burden in Pakistan.