title: Integrating sepsis management recommendations into clinical care guidelines for district hospitals in resource-limited settings: the necessity to augment new guidelines with future research.
abstract: Several factors contribute to the high mortality attributed to severe infections in resource-limited settings. While improvements in survival and processes of care have been made in high-income settings among patients with severe conditions, such as sepsis, guidelines necessary for achieving these improvements may lack applicability or have not been tested in resource-limited settings. The World Health Organization's recent publication of the Integrated Management of Adolescent and Adult Illness District Clinician Manual provides details on how to optimize management of severely ill, hospitalized patients in such settings, including specific guidance on the management of patients with septic shock and respiratory failure without shock. This manuscript provides the context, process and underpinnings of these sepsis guidelines. In light of the current deficits in care and the limitations associated with these guidelines, the authors propose implementing these standardized best practice guidelines while using them as a foundation for sepsis research undertaken in, and directly relevant to, resource-limited settings.
authors.affiliation: International Respiratory and Severe Illness Center (INTERSECT), Department of Medicine, University of Washington, 325 9th Ave, Box 359927, Seattle, WA 98104, USA. sjacob2@uw.edu
authors.forename: Shevin T
authors.initials: ST
authors.lastname: Jacob
authors.forename: Matthew
authors.initials: M
authors.lastname: Lim
authors.forename: Patrick
authors.initials: P
authors.lastname: Banura
authors.forename: Satish
authors.initials: S
authors.lastname: Bhagwanjee
authors.forename: Julian
authors.initials: J
authors.lastname: Bion
authors.forename: Allen C
authors.initials: AC
authors.lastname: Cheng
authors.forename: Hillary
authors.initials: H
authors.lastname: Cohen
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
authors.forename: Sandy
authors.initials: S
authors.lastname: Gove
authors.forename: Philip
authors.initials: P
authors.lastname: Hopewell
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Moore
authors.forename: Cathy
authors.initials: C
authors.lastname: Roth
authors.forename: T Eoin
authors.initials: TE
authors.lastname: West
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D016638:Critical Illness; D006767:Hospitals, District; D006801:Humans; D017410:Practice Guidelines as Topic; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control