Integrating Antimicrobial Resistance Surveillance and Antibiotic Stewardship in Community-Acquired Sepsis: Implications for Early Empirical Treatment
DOI:
https://doi.org/10.64784/338Palabras clave:
antimicrobial resistance, community-acquired sepsis, antimicrobial stewardship, empirical antibiotic therapy, epidemiological surveillance, antibiotic resistance, sepsis, antimicrobial de-escalation, procalcitonin, rational antibiotic useResumen
Antimicrobial resistance represents a growing challenge in the management of community-acquired sepsis because it reduces the effectiveness of conventional empirical therapy and increases the complexity of initial clinical decision-making. This study analyzed the relationship between antimicrobial resistance, epidemiological surveillance, empirical antimicrobial treatment, and antimicrobial stewardship in adult patients with community-acquired sepsis. A structured integrative review based on the Scientific Method was conducted using scientific literature, clinical guidelines, and international surveillance reports. The evidence showed that resistant microorganisms are increasingly relevant in community-onset infections and that both inadequate initial antimicrobial coverage and unnecessarily broad-spectrum therapy may be associated with unfavorable clinical outcomes. Previous antimicrobial exposure, history of resistant organisms, prior Gram-negative infections, infection source, and local susceptibility patterns were identified as important variables for estimating the probability of resistance. Epidemiological surveillance and local antibiograms were essential for guiding empirical therapy, while microbiological reassessment and antimicrobial de-escalation contributed to reducing unnecessary exposure. Procalcitonin-guided strategies were also associated with shorter antibiotic treatment duration when integrated with clinical judgment. Overall, the findings support an individualized approach based on early recognition of sepsis, appropriate empirical treatment, assessment of resistance risk, microbiological diagnosis, and systematic therapeutic reassessment. Integrating clinical management with surveillance and antimicrobial stewardship may improve therapeutic precision while contributing to the preservation of antimicrobial effectiveness.
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