Emergency medicine pharmacists and sepsis management

To describe the role that an emergency medicine (EM) clinical pharmacist has on the management of patients presenting to the emergency department (ED) with sepsis, severe sepsis, or septic shock.

The clinical consultations documented by the EM pharmacists at an academic, teaching hospital over a 2-year period were retrospectively reviewed.

During the study period, a total of 585 consultations were provided by the EM pharmacists to 130 patients who presented to the ED with a diagnosis of sepsis, severe sepsis, or septic shock. Dosing recommendations were the most frequent consultations provided (n = 309, 53%), followed by the addition of appropriate empiric antibiotics (n = 131, 22%) and medication preparation (n = 108, 19%). Antibiotics (n = 307, 83%) and vasopressors (n = 31, 8%) were the medication classes regularly involved in EM pharmacist consultations. Vancomycin (n = 90, 28%) and norepinephrine (n = 15, 48%) were the most common agents involved in these consultations.

A clinical EM pharmacist has multiple roles in the early management of patients presenting with sepsis, severe sepsis, or septic shock in the ED. Most commonly, they have a role in optimizing empiric antibiotic selection and dosing; thereby ensuring adequate antimicrobial coverage in this complex patient population.