Sepsis is currently defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis and septic shock are common reasons for intensive care unit (ICU) admission and have high mortality rates, even at long-term follow-up. In 2004, the estimated annual number of admissions for severe sepsis in Dutch ICU’s was 7700 to 9500. The incidence of sepsis may have risen in recent decennia, possibly due to ageing and increasing numbers of immunocompromised patients. Antibacterial therapy is an essential part of effective sepsis treatment. Inappropriate or delayed antibacterial treatment in patients with sepsis and septic shock are associated with increased morbidity and mortality.
The Dutch Working Party on Antibiotic Policy (SWAB), initiated by the Dutch Association of Internal Medicine, the Dutch Society for Medical Microbiology and the Dutch Association of Hospital Pharmacists, coordinates activities in the Netherlands with the aim to optimize antibiotic use, to contain the development of antimicrobial resistance, and to limit the costs of antibiotic use. For this purpose, SWAB develops evidence-based guidelines on antibiotic treatment, intended for the Dutch situation. SWAB also yearly reports on the use of antibiotics and on trends in antimicrobial resistance in The Netherlands in NethMap (available from www.swab.nl), in collaboration with the Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (CIb-RIVM).
The general objective of the SWAB sepsis guideline is to guide medical professionals in empirical antibacterial treatment for adults with sepsis and septic shock in hospitals in the Netherlands. The current guideline on empirical antibacterial therapy of sepsis in the Netherlands is an update of the SWAB sepsis guideline published in 2010. The first step for the update included the establishment of a guideline committee with individuals from all relevant Dutch professional medical societies involved in the care for adults with sepsis. The group included experts in the field of sepsis and methodology.