Monotherapy for Patients with Severe Sepsis?

The necessity of combined antibiotic therapy for the management of severe infection has been debated for decades. Given recent data indicating increased morbidity and mortality in patients with septic shock who receive inappropriate initial antibiotic therapy, investigators in Germany undertook a multicenter, controlled trial comparing meropenem monotherapy against meropenem plus moxifloxacin in patients with severe sepsis or septic shock. Individuals known to have been previously infected or colonized with methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus species were excluded.

Among 600 patients from 44 intensive care units who were randomized, 551 were evaluable for efficacy. One third of these evaluable pat…