Expert Panel Defines Strategies to Improve Sepsis Care

A multisociety position paper published in Clinical Infectious Diseases outlines hospital-level strategies intended to strengthen infection-related sepsis care across diagnosis, early management, reassessment, prevention, and performance measurement.

The Infectious Diseases Society of America convened a multidisciplinary panel with representatives from 8 other professional societies and the Sepsis Alliance. The 24-member voting panel developed recommendations across 6 domains: diagnostic testing and pathogen detection, antimicrobial management and delivery, surveillance and performance metrics, adjunctive therapy, program infrastructure and organizational support, and infection prevention.

Using a modified Delphi process, panelists scored proposed strategies for potential effect on outcomes, opportunity, feasibility, unintended consequences, and overall implementation priority. Tier 1 recommendations included pairing multiplex nucleic acid amplification testing of positive blood cultures with active antimicrobial stewardship; targeting antibiotic administration within 1 hour of septic shock recognition; minimizing order-to-infusion time; using clinical decision support to prioritize beta-lactam administration before vancomycin when both are ordered; and defaulting antipseudomonal beta-lactams to prolonged infusion after a loading dose in critically ill patients with sepsis.

Tier 2 recommendations included electronic health record-based surveillance, monitoring inadequate and unnecessarily broad empiric therapy, measuring antibiotic de-escalation and timeliness of source control, and establishing protocols for corticosteroid use in selected patients. The panel also supported multidisciplinary sepsis governance and infection-prevention measures, including chlorhexidine bathing with nasal decolonization in specified high-risk patients and structured daily toothbrushing programs. Automated prediction tools and several novel diagnostic approaches were classified as emerging and promising, not ready for routine implementation.

The authors said the recommendations should complement, rather than replace, existing bedside guidance and quality measures. They also noted that no formal systematic review was performed, evidence for some strategies was indirect or observational, and implementation may be constrained by local resources. The framework was developed primarily for US hospitals, with pediatric caveats and neonatal sepsis outside its scope.

Source: Rhee C, Masur H, Klompas M, et al. IDSA/ACEP/ASM/PIDS/SCCM/SHEA/SHM/SIDP multisociety position paper: hospital strategies to improve sepsis outcomes. Clin Infect Dis. Published online August 25, 2026. doi:10.1093/cid/ciag438