Rising Medical Costs Mean More Rough Times Ahead.

administered antibiotics, fluids, or both, improve sepsis survival compared with usual care. These trials could usher in a new approachforthediagnosisandtreatmentofsepsis that starts in the ambulance, not the ED. Angus believes that in the future, randomized trials could be possible in a “Goldilocks” cohort of hospital patients with low or intermediate suspicion of infection and sepsis whomight be harmed by aggressive treatment. “Theremaybean ‘on-the-fence’ group inwhomclinicianswould agree there is adequateequipoise” to conduct a trial, he said. However, he added that identifying thesepatientsquicklywill requiremorerapid diagnostics than are currently available— likely a combination of clinical tests and pathogen or host response biomarkers.