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Whats New in the
Patient Safety World
June 2026
Surviving Sepsis
Campaign 2026 Guideline Update
The Surviving Sepsis Campaign has just published updated guidelines on sepsis care (Prescott 2026), the first update since 2021. It is a pretty long document, including 129 statements, with 46 being new statements not previously addressed and more definitive recommendations.
A simple summary of changes would have been nice but the Table of Statements includes all the statements along with strength of recommendation, certainty of evidence, and whether the statement is a carryover statement or one that is new, revised, or revisited without change. Arrows also indicate whether the strength of recommendation or certainty of evidence has been upgraded or downgraded.
A full description is well beyond the scope of todays column, so we refer you to the full document or to the Table of Statements. Well comment on just a few of the new or upgraded recommendations.
One of the new
recommendations deals with patients before they reach the hospital (such as
those being transported via ambulance or air). The panel recommended using a
standard sepsis screening tool to identify patients with likely sepsis sooner.
So, patients with probable sepsis, low blood pressure, and those who are facing
prolonged travel time to the hospital are recommended for antimicrobial therapy
while enroute to hospital.
Another new
recommendation is to not use anti-anaerobic antibiotics in patients at low risk
for an anaerobic infection. The guideline points out that the urinary and
pulmonary infections that most often lead to sepsis are far more likely to be
caused by aerobic bacteria. Use of broad-spectrum antibiotics, which target all
types of bacteria, kill off the gut microbiome and may lead to higher
mortality. The guideline also recommends not using empiric anti-fungal therapy
outside rare case-by-case situations in patients at very high risk of fungal
infection.
One statement that was upgraded is the recommendation for de-escalation of antimicrobials over using fixed durations of therapy without daily reassessment for de-escalation. (De-escalation involves discontinuing unnecessary antimicrobial therapy or narrowing the spectrum of antimicrobial agents where appropriate.)
We suggest clinicians from your ICU staff or Infectious Disease staff prepare a summary of this lengthy guideline for presentation to staff in multiple disciplines.
Our other columns on sepsis:
· March 15, 2011 Early Warnings for Sepsis
· April 1, 2014 Expensive Aspects of Sepsis Protocol Debunked
·
September
8, 2015 TREWScore for Early Recognition of Sepsis
·
October
2015 Even Earlier Recognition of Severe Sepsis
·
February
2, 2016 Success
Against Sepsis
·
March
2016 Finally
A
More Rationale Definition for Sepsis
·
February
2017 Yes,
the New Sepsis Criteria Fit the Bill
·
June 6,
2017 NYS
Mandate for Sepsis Protocol Works
·
July
2021 Adverse
Effects of Contact Isolation in the COVID-19 Era
·
July
2021 EPIC Sepsis Prediction Tool
Falls Short
· February 2026 Sequential Organ Failure Assessment (SOFA)-2 Score
References:
Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Critical Care Medicine 2026; Published online March 23, 2026
https://journals.lww.com/ccmjournal/fulltext/9900/surviving_sepsis_campaign__international.786.aspx
Table of Statements
https://journals.lww.com/ccmjournal/_layouts/15/oaks.journals/ImageView.aspx?k=ccmjournal:9900:00000:00786&i=T1&year=9900&issue=00000&article=00786&type=Fulltext
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