Letters

More on pneumonia: “Surviving Sepsis” campaign may contradict CURB score

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7553.1333-b (Published 01 June 2006) Cite this as: BMJ 2006;332:1333
  1. Thomas M Oates (oates_tom{at}hotmail.com), senior house officer
  1. Charing Cross Hospital, London W6 8RF

    EDITOR—Owen et al highlight the possibility that intravenous antibiotics may be overprescribed to patients with non-severe community acquired pneumonia.1 The guidelines of the “Surviving Sepsis” campaign for managing severe sepsis and septic shock recommend “intravenous antibiotic treatment should be started within the first hour of recognition of severe sepsis, after appropriate cultures.”2

    Some of the literature referenced by the Surviving Sepsis campaign uses the fulfilment of two out of four of the criteria for the systemic inflammatory response syndrome and a systolic blood pressure less than 90 mm Hg as indicative of sepsis. Given the difference between these criteria and CURB criteria, a patient apparently not deemed suitable for intravenous antibiotic treatment of pneumonia by the CURB criteria could be recommended for aggressive treatment of sepsis (including central venous and arterial access) by the campaign's guidelines.

    This apparent contradiction illustrates the continued importance of overall clinical assessment in our increasingly guideline driven management of patients.

    Footnotes

    • Competing interests None declared.

    References

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