In the IDWeek 2023 presentation titled The Role of ID Physicians and Pharmacists in Stewardship Sepsis, Sara Cosgrove, MD, MS, professor of medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, delineated how ID practitioners can positively influence the impact of sepsis infection response by being “an astute clinician” and leading by example to educate others on making infectious diseases and noninfectious diseases diagnoses, applying principles of antibiotic stewardship while understanding what their institutions are doing to ensure compliance.

Dr. Cosgrove emphasized the importance of antibiotic selection and re-evaluation during care transition upon transfer from emergency departments to inpatient units, from ICUs to hospital floors; during hand-offs between providers, and prior to discharge.

“It is important to address behavioral issues that prevent re-evaluation,” she cautioned. “Understanding how sick a patient is and what is wrong changes over time.”

Specifically, she called for assisting with development and evaluation of tools for early detection of sepsis and discouraged documenting “every presentation as possible sepsis.” She also recommended ensuring that strategies are in place so that patients receive appropriate spectrum antibiotics in a timely fashion when they are needed (e.g., guidelines, order sets). Dr. Cosgrove also called for developing approaches to ensure that frontline providers reassess antibiotic choice and need on a daily basis and during care transitions.

Finally, she recommended developing approaches and algorithms to assist with interpretation of clinical findings, rapid diagnostic tests, and biomarkers, as well as formulating recommendations for therapy duration. There should also be approaches developed to prompt prescribers to stop antibiotics after the designated course is complete, she added.