Experts Call for Modification to Sepsis Definition for Better Patient Outcomes

Updated June 04, 2025

A revised operational definition for sepsis
⁤ could lead to improved patient ⁣outcomes by allowing ⁢health care providers to concentrate on severely ill
individuals,⁣ according to experts. Such a change could also aid in antibiotic⁢ stewardship efforts.

Drs. Michael Klompas and Chau Rhee noted that sepsis is generally defined in two ways: as “life-threatening organ
dysfunction caused by a dysregulated host response to‍ infection” and as “suspected infection, at least two
systemic inflammatory response signs, and acute organ dysfunction.”

Klompas and⁤ Rhee suggest modifying operational definitions of sepsis
‍ ⁢ to⁤ identify patients where short antibiotic delays correlate with increased mortality.This, they argue, will
⁣ focus sepsis care “where it is needed” and enhance the validity of sepsis quality measures.

Klompas,an infectious disease physician at Brigham and Women’s Hospital,discussed sepsis guidance and⁢ proposed
changes.

“Clinicians have been trained to treat ⁢all patients ‍with possible sepsis immediately, aggressively and uniformly
with ⁣broad-spectrum antibiotics,” Klompas⁢ and Rhee wrote. “Evidence ⁤continues to mount, however, ‍that
⁢ immediate antibiotics ⁤are only critical for patients with septic shock or multiorgan dysfunction, while patients
with single⁢ organ dysfunction without shock can safely tolerate short delays until antibiotics. This allows time
⁣ to clarify‍ whether these patients are infected or not.”

“Our concern⁣ is ⁤that in practice ‍these operational criteria identify patients with a⁢ very wide spectrum of
⁣ illness, some ⁢of whom are indeed critically ill and really need immediate care, but also ⁢many patients with
‍ ⁢ milder illness who do not need antibiotics immediately,” klompas said.

Klompas added ⁢that about one-third of patients treated for possible sepsis have⁢ nonbacterial infections or
noninfectious⁤ conditions mimicking sepsis, exposing them to antibiotic risks without potential benefits. He
⁢ believes⁣ overtreatment stems from pressure to treat all possible sepsis cases rapidly, leaving insufficient time
⁣ to determine the presence and nature of infection.

“The term sepsis should be reserved for patients with⁣ infections in whom⁣ delays in antibiotics are associated
⁣ with increased mortality. Other patients⁤ should not be labeled as having⁣ sepsis,” Klompas said.

What’s next

While infectious disease, emergency medicine, hospitalist, pharmacy, and infection control professional societies
⁤ largely agree that current sepsis recommendations are too broad, critical care and pulmonary⁣ societies favor a
⁤ more inclusive approach. ⁤Further consensus-building is needed among all stakeholders.