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Lancet Infect Dis. 2015 May;15(5):581-614. doi: 10.1016/S1473-3099(15)70112-X. Epub 2015 Apr 19.

Sepsis: a roadmap for future research.

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Brighton and Sussex Medical School, Brighton, UK. Electronic address:
University of Brussels, Erasme University Hospital, Brussels, Belgium.
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada.
Department of Anesthesiology and Intensive Care, Federal University of São Paulo, São Paulo, Brazil.
Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Infectious Diseases Service and Institute of Microbiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Infectious Disease Division, Alpert Medical School of Brown University, Providence, RI, USA.
Feinstein Institute for Medical Research, Manhasset, NY, USA.
Centre of Experimental and Molecular Medicine, Academic Medical Centre, University of Amsterdam, Netherlands; Division of Infectious Diseases, Academic Medical Centre, University of Amsterdam, Netherlands.
Office of Anti-infectives and Vaccines, Human Medicines Evaluation Division, European Medicines Agency, London, UK.

Erratum in


Sepsis is a common and lethal syndrome: although outcomes have improved, mortality remains high. No specific anti-sepsis treatments exist; as such, management of patients relies mainly on early recognition allowing correct therapeutic measures to be started rapidly, including administration of appropriate antibiotics, source control measures when necessary, and resuscitation with intravenous fluids and vasoactive drugs when needed. Although substantial developments have been made in the understanding of the basic pathogenesis of sepsis and the complex interplay of host, pathogen, and environment that affect the incidence and course of the disease, sepsis has stubbornly resisted all efforts to successfully develop and then deploy new and improved treatments. Existing models of clinical research seem increasingly unlikely to produce new therapies that will result in a step change in clinical outcomes. In this Commission, we set out our understanding of the clinical epidemiology and management of sepsis and then ask how the present approaches might be challenged to develop a new roadmap for future research.

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