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Whether combination antibiotic treatment is beneficial for patients with severe sepsis or septic shock remains controversial, despite several published studies. Now, this topic has been readdressed in two large cohort studies.
Kumar and colleagues assessed 28-day mortality among consecutive adults with culture-positive, bacterial septic shock at 28 hospitals in the U.S., Canada, and Saudi Arabia. They analyzed data on 4662 patients, of whom 63% had received one antibiotic appropriate to the primary pathogen isolated and 37% had received more than one such agent. In a Cox proportional-hazards model using 1223 propensity-matched pairs, combination therapy was associated with lower 28-day mortality than monotherapy (29% vs. 36%; P=0.0002). It w…