Treatments of Sepsis and Septic Shock: Advancements in Controversy

Sepsis and septic shock are among the leading causes of death in critically ill patients. Since considerable advances have been made in understanding their pathophysiology and clinical management, the Surviving Sepsis Campaign(SSC) guideline for sepsis and septic shock is updated every four years since 2004, which aims at standardizing the clinical practice. The mortality of sepsis was significantly decreased based on the data from the last decades. The recent update of SSC was released in 2016, but it was argued against by Infectious Disease Society of America(IDSA) regarding antimicrobial therapy. IDSA published a statement on its official journal, Clinical Infectious Diseases, claiming they did not endorse the SSC guideline, which caused some confusion in clinical references and applications. So it is important to understand the essence of the controversy between these two societies. The guidelines of SSC and IDSA can better instruct the clinical practice for sepsis and septic shock only after the core of the contradiction between them is fully understood.