Intended for healthcare professionals


Sepsis: getting the balance right

BMJ 2019; 367 doi: (Published 28 November 2019) Cite this as: BMJ 2019;367:l6700
  1. Paul Morgan, consultant intensivist1,
  2. Azeem Majeed, professor of primary care2
  1. 1Critical Care Directorate, University Hospital of Wales, Cardiff, UK
  2. 2Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
  1. Correspondence to: P Morgan Paul.Morgan5{at}
    Follow Paul Morgan on Twitter @drpaulmorgan

We must strive for prompt treatment without overdiagnosis

Public and professional understanding of sepsis has increased greatly in recent years.1 This has led to campaigns to diagnose sepsis early in the clinical course of the illness and to start treatment with antibiotics and fluid replacement promptly. Examples include the Survive Sepsis campaign, which led to the creation of the UK Sepsis Trust, and the establishment of the Global Sepsis Alliance and World Sepsis Day. But could this pressure to improve sepsis management be counterproductive and lead to overdiagnosis of sepsis? This was the argument made by the authors of a recent letter to the Lancet.2

One problem arising from overdiagnosis of sepsis is the overuse of broad spectrum antibiotics. Another concern is that the emphasis on the early treatment of sepsis detracts from the recognition, diagnosis, and treatment of other acute illnesses. Only a small percentage of acute infections lead to sepsis, …

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