Management of severe bacterial infections

Defining the severity of an infection can play a central role for a correct therapeutic choice, avoiding inadequate antimicrobial treatments. Severe bacterial infections are, in fact, characterized by high morbidity and mortality rates so that the appropriateness of therapy can have a profound clinical impact. Indeed, initial inappropriate empirical therapies, and the further need to modify them, substantially increase the mortality risk. Several strategies have been suggested to improve the clinical outcome of patients affected by severe bacterial infections, such as the use of guidelines, use of antibiotics in combination, de-escalation therapy, cycling therapy and the use of infectious disease specialist consultation. A closer collaboration between the medical staff in the wards and infectious disease specialists can possibly bridge the gap between different strategies and individual needs of the patient, thereby improving the decision-making process.