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Antibiotics
Special Issues
Sepsis Management and Antibiotic Therapy
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Sepsis Management and Antibiotic Therapy

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 7209

Special Issue Editor

Prof. Dr. Egidia Gabriela Miftode

E-Mail Website
Guest Editor
1. Department of Internal Medicine II, Faculty of Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
2. “St. Parascheva” Clinical Hospital of Infectious Diseases, 700116 Iași, Romania
Interests: infectious diseases; multidrug-resistant (MDR); clostridium difficile; bacterial meningitis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Sepsis is a severe medical condition that requires urgent attention and prompt treatment. It occurs when the body's immune system overreacts to an infection, leading to inflammation and damage to tissues and organs. Sepsis can quickly progress into septic shock, which can be life-threatening. Antibiotic therapy is a critical component of sepsis management, helping to kill bacteria causing infection and prevent its spread throughout the body. However, the overuse and misuse of antibiotics have led to the emergence of antibiotic-resistant bacteria, which pose a significant challenge to sepsis management.

This Special Issue aims to provide an overview of the current best practices in Sepsis Management and Antibiotic Therapy, publishing the latest research, guidelines, and clinical recommendations. Submissions to this issue should include topics such as the use of biomarkers for sepsis management, the role of antimicrobial stewardship in preventing antibiotic resistance, and emerging therapies for sepsis treatment.

Prof. Dr. Egidia Gabriela Miftode
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sepsis
  • antibiotic therapy
  • infection
  • antimicrobial
  • antifungal

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Published Papers (4 papers)

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Research

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8 pages, 787 KiB  
Article
Can a Shorter Dwell Time Reduce Infective Complications Associated with the Use of Umbilical Catheters?
by Martina Buttera, Lucia Corso, Leonardo Casadei, Cinzia Valenza, Francesca Sforza, Francesco Candia, Francesca Miselli, Cecilia Baraldi, Licia Lugli, Alberto Berardi and Lorenzo Iughetti
Antibiotics 2024, 13(10), 988; https://doi.org/10.3390/antibiotics13100988 - 18 Oct 2024
Viewed by 914
Abstract
Background: Umbilical venous catheters (UVCs) are the standard of care in neonatal intensive care units (NICUs) to administer fluids, parenteral nutrition and medications, although complications may occur, including central line-associated blood stream infections (CLABSIs). However, the dwell time to reduce CLABSI risk remains [...] Read more.
Background: Umbilical venous catheters (UVCs) are the standard of care in neonatal intensive care units (NICUs) to administer fluids, parenteral nutrition and medications, although complications may occur, including central line-associated blood stream infections (CLABSIs). However, the dwell time to reduce CLABSI risk remains an open issue. Methods: We performed a single-center retrospective study of newborns hospitalized in the Modena NICU with at least one UVC inserted over a 6-year period (period 1: January 2011–December 2013; period 2: January 2019–December 2021). We selected a non-consecutive 6-year period to emphasize the differences in UVC management practices that have occurred over time in our NICU. The UVC dwell time and catheter-related complications during the first 4 weeks of life were examined. Results: The UVC dwell time was shorter in period 2 (median 4 days vs. 5 days, p < 0.00001). Between the two periods, the incidence of CLABSIs remained unchanged (p = 0.5425). However, in period 2, there was an increased need for peripherally inserted central catheters (PICCs) after UVC removal, with a rise in PICC infections after UVC removal (p = 0.0239). Conclusions: In our NICU, shortening UVC dwell time from 5 to 4 days did not decrease the UVC-related complications. Instead, the earlier removal of UVCs led to a higher number of PICCs inserted, possibly increasing the overall infectious risk. Full article
(This article belongs to the Special Issue Sepsis Management and Antibiotic Therapy)
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7 pages, 215 KiB  
Article
Occult Serious Bacterial Infections in Neonates and Infants Up to Three Months of Age with Bronchiolitis: Are Invasive Cultures Required?
by Domenico Umberto De Rose, Venere Cortazzo, Marilena Agosta, Paola Bernaschi, Maria Paola Ronchetti, Velia Chiara Di Maio, Alessandra Di Pede, Jole Rechichi, Annabella Braguglia, Carlo Federico Perno and Andrea Dotta
Antibiotics 2024, 13(8), 702; https://doi.org/10.3390/antibiotics13080702 - 26 Jul 2024
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Abstract
(1) Background: The literature reports a low risk of serious bacterial infections (SBIs) in febrile infants presenting with bronchiolitis or respiratory syncytial virus infection, but current microbiological techniques have a higher accuracy. (2) Methods: We assessed the risk of SBIs in neonates and [...] Read more.
(1) Background: The literature reports a low risk of serious bacterial infections (SBIs) in febrile infants presenting with bronchiolitis or respiratory syncytial virus infection, but current microbiological techniques have a higher accuracy. (2) Methods: We assessed the risk of SBIs in neonates and infants with bronchiolitis from 2021 to 2023. We also evaluated C-reactive protein, procalcitonin, and leukocyte values. (3) Results: We included 242 infants. Blood cultures (BCs) were performed in 66/242 patients, with a positivity rate of 9.1% (including one BC with Staphylococcus hominis, considered as a contaminant). The cerebrospinal fluid culture was performed in 6/242 patients, and the results were all negative. Infection markers did not discriminate infants with positive BCs from those with negative ones. (4) Conclusions: Blood cultures should be performed in neonates and young infants with bronchiolitis fever, as the sepsis risk is not negligible. Conversely, our proposed algorithm is to wait for the respiratory panel results before decision-making for a lumbar puncture. Further studies are needed to understand lumbar puncture requirements. Full article
(This article belongs to the Special Issue Sepsis Management and Antibiotic Therapy)
13 pages, 1305 KiB  
Article
Emergence of High-Level Gentamicin Resistance in Streptococcus agalactiae Hypervirulent Serotype IV ST1010 (CC452) Strains by Acquisition of a Novel Integrative and Conjugative Element
by Roberta Creti, Monica Imperi, Uzma Basit Khan, Alberto Berardi, Simona Recchia, Giovanna Alfarone and Giovanni Gherardi
Antibiotics 2024, 13(6), 491; https://doi.org/10.3390/antibiotics13060491 - 26 May 2024
Cited by 1 | Viewed by 1964
Abstract
Streptococcus agalactiae (group B streptococci, GBS) is responsible for severe infections in both neonates and adults. Currently, empiric antimicrobial therapy for sepsis and meningitis is the combined use of penicillin and gentamicin due to the enhanced bactericidal activity. However, high-level gentamicin resistance (HLGR) [...] Read more.
Streptococcus agalactiae (group B streptococci, GBS) is responsible for severe infections in both neonates and adults. Currently, empiric antimicrobial therapy for sepsis and meningitis is the combined use of penicillin and gentamicin due to the enhanced bactericidal activity. However, high-level gentamicin resistance (HLGR) abrogates the synergism. The rate of HLGR was investigated within a dataset of 433 GBS strains collected from cases of invasive disease in both adults and neonates as well as from pregnant carriers. GBS isolates (n = 20, 4.6%) presented with HLGR (gentamicin MIC breakpoint >1024 mg/L) that was differently diffused between strains from adults or neonates (5.2% vs. 2.8%). Notably, 70% of HLGR GBS strains (14 isolates) were serotype IV. Serotype IV HLGR-GBS isolates were susceptible to all antibiotics tested, exhibited the alpha-C/HvgA/PI-2b virulence string, and belonged to sequence type 1010 (clonal complex (CC) 452). The mobile element that harbored the HLGR aac(6′)-aph(2)″ gene is a novel integrative and conjugative element (ICE) about 45 kb long, derived from GBS 515 ICE tRNALys. The clonal expansion of this HLGR hypervirulent serotype IV GBS CC452 sublineage may pose a threat to the management of infections caused by this strain type. Full article
(This article belongs to the Special Issue Sepsis Management and Antibiotic Therapy)
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Review

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30 pages, 2194 KiB  
Review
Multidisciplinary Perspectives of Challenges in Infective Endocarditis Complicated by Septic Embolic-Induced Acute Myocardial Infarction
by Elena Stamate, Oana Roxana Ciobotaru, Manuela Arbune, Alin Ionut Piraianu, Oana Monica Duca, Ana Fulga, Iuliu Fulga, Alexia Anastasia Stefania Balta, Adrian George Dumitrascu and Octavian Catalin Ciobotaru
Antibiotics 2024, 13(6), 513; https://doi.org/10.3390/antibiotics13060513 - 31 May 2024
Viewed by 2419
Abstract
Background: Infective endocarditis (IE) management is challenging, usually requiring multidisciplinary collaboration from cardiologists, infectious disease specialists, interventional cardiologists, and cardiovascular surgeons, as more than half of the cases will require surgical procedures. Therefore, it is essential for all healthcare providers involved in managing [...] Read more.
Background: Infective endocarditis (IE) management is challenging, usually requiring multidisciplinary collaboration from cardiologists, infectious disease specialists, interventional cardiologists, and cardiovascular surgeons, as more than half of the cases will require surgical procedures. Therefore, it is essential for all healthcare providers involved in managing IE to understand the disease’s characteristics, potential complications, and treatment options. While systemic embolization is one of the most frequent complications of IE, the coronary localization of emboli causing acute myocardial infarction (AMI) is less common, with an incidence ranging from 1% to 10% of cases, but it has a much higher rate of morbidity and mortality. There are no guidelines for this type of AMI management in IE. Methods: This narrative review summarizes the current knowledge regarding septic coronary embolization in patients with IE. Additionally, this paper highlights the diagnosis and management challenges in such cases, particularly due to the lack of protocols or consensus in the field. Results: Data extracted from case reports indicate that septic coronary embolization often occurs within the first two weeks of the disease. The aortic valve is most commonly involved with vegetation, and the occluded vessel is frequently the left anterior descending artery. Broad-spectrum antibiotic therapy followed by targeted antibiotic therapy for infection control is essential, and surgical treatment offers promising results through surgical embolectomy, concomitant with valve replacement or aspiration thrombectomy, with or without subsequent stent insertion. Thrombolytics are to be avoided due to the increased risk of bleeding. Conclusions: All these aspects should constitute future lines of research, allowing the integration of all current knowledge from multidisciplinary team studies on larger patient cohorts and, subsequently, creating a consensus for assessing the risk and guiding the management of this potentially fatal complication. Full article
(This article belongs to the Special Issue Sepsis Management and Antibiotic Therapy)
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