Advances in the management of sepsis: the randomised controlled trials behind the Surviving Sepsis Campaign recommendations

The Surviving Sepsis Campaign is the first international, multiorganisation, multidisciplinary attempt to reduce the appalling morbidity and mortality related to sepsis. Under the auspices of the campaign, guidelines have been published that cover more than 50 aspects of care of the septic patient. Campaign guidelines on antimicrobial therapy cover very general aspects of antibiotic policy and are mostly supported by expert opinion rather than randomised controlled trials. However, these ‘common sense’ recommendations on antibiotic therapy have been included in this review. The core areas of the Surviving Sepsis Campaign guidelines have been crystallised into resuscitation and management ‘bundles’. This review focuses on the most important clinical trials that form the basis of these core guidelines.