Efficacy of Early Targeted Antibiotic Therapy in Patients with Sepsis and Septic Shock

Momtaz, Iman M.; El Bassiouny, Noha; Afify, Mohamed; Werida, Rehab H.

doi:10.21608/jampr.2025.366679.1090

Efficacy of Early Targeted Antibiotic Therapy in Patients with Sepsis and Septic Shock

Document Type : Original Article

Authors

¹ Ministry of Health and Population, Alexandria City, Egypt

² Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt

³ Critical Care department, Faculty of Medicine, Cairo University, Egypt

10.21608/jampr.2025.366679.1090

Abstract

Background and objective
Sepsis and septic shock carry a high mortality rate, necessitating prompt treatment. As antibiotic-resistant pathogens become more prevalent, genotyping offers a potential advantage by quickly identifying organisms and their resistance genes. This study evaluated whether genotyping-targeted antibiotic therapy improved outcomes over conventional bacterial culture-based treatment in patients with sepsis or septic shock, with a focus on correlating Sirtuin1 levels with the inflammatory response and mortality risk.
Methods
This prospective, single-center, open labeled, randomized clinical trial involved 52 patients with sepsis or septic shock randomly assigned to either conventional bacterial culture or genotyping targeted antibiotics. Blood samples were collected on Day 1 and Day 5 to measure sepsis markers; C-reactive protein (CRP), procalcitonin (PCT), total leukocyte count (TLC), and Sirtuin 1 and changes in SOFA scores were assessed.
Results
The intervention did not differ significantly from conventional culture-based therapy in terms of the percentage change of SOFA scores (p=0.679) or ventilator-free days (p=0.362). Similarly, changes in TLC (p=0.522), PCT (p=0.067), and Sirtuin 1 (p=0.227) showed no statistically significant differences, although CRP was the only marker with a significant percentage change (p=0.042). Mortality rates, length of hospital stay, and 30-day mortality also did not differ significantly (p=0.668, p=0.594, and p=1.00, respectively).
Conclusion
The current research discovered that incorporating genotyping in patients with sepsis and septic shock did not result in differences in the prognosis and mortality of these patients. Additionally, the level of Sirtuin 1 did not reflect either improvement or mortality in this specific group of individuals.

Keywords