Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliation: Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Seville, Spain (email@example.com).
To the Editor: In the study by Dr Brunkhorst and colleagues,1 the effect of empirical treatment with moxifloxacin and meropenem on sepsis-related organ dysfunction in patients with severe sepsis was compared with meropenem alone. Randomized clinical trials usually compare a new treatment or concept with the standard of care. In this trial, none of the groups were provided the standard of care. The authors stated that they excluded patients with “ . . . infections for which the guidelines recommend an antimicrobial therapy other than the study medication (ie, endocarditis). . . . ” However, 50.3% of included patients had a community-acquired infection. Meropenem should not be considered the standard of care for most community-acquired infections, even if presenting with severe sepsis because the majority of patients can be treated with narrower-spectrum agents.
Rodríguez-Baño J. Treatment of Sepsis-Related Organ Dysfunction. JAMA. 2012;308(12):1205-1206. doi:10.1001/2012.jama.11262