Sepsis remains a significant cause of mortality in intensive care units (ICUs) globally, despite advancements in early detection and treatment. One critical aspect often overlooked in sepsis management is the impact of sex-related physiology and gender-based care disparities on antibiotic dosing protocols. A recent editorial published in the Journal of Intensive Medicine sheds light on how these factors can lead to suboptimal treatment, particularly affecting women’s outcomes.
Authored by Dr. Helena Barrasa, Dr. Goiatz Balziskueta, and Prof. Jordi Rello, the editorial underscores the importance of recognizing biological sex and gender inequities in sepsis care. It emphasizes that men and women exhibit distinct pharmacokinetic and pharmacodynamic differences that should be considered when determining antibiotic dosages. For instance, women are often underrepresented in clinical trials, putting them at a higher risk of antibiotic overexposure due to factors like hormonal fluctuations and body composition. On the other hand, men, especially those with augmented renal clearance, may be underdosed, leading to ineffective treatment.
The authors highlight that standardized dosing practices fail to account for these crucial biological variations. Women, with their altered metabolism and lower muscle mass, are more susceptible to adverse effects, while younger men may eliminate drugs too rapidly to maintain therapeutic levels. Moreover, gender biases and stereotypes further complicate sepsis care, with women less likely to receive aggressive interventions compared to men, often due to symptom misinterpretation or healthcare-seeking behaviors.
To address these disparities, the editorial advocates for the integration of sex and gender considerations into antimicrobial dosing guidelines. It calls for the widespread adoption of therapeutic drug monitoring to tailor treatment to individual patients and reduce toxicity and resistance risks. Additionally, the authors stress the importance of incorporating sex- and gender-aware research protocols in scientific studies, as less than 30% of current research reports include sex-stratified data.
In conclusion, Prof. Rello emphasizes that understanding and addressing the differences influenced by sex and gender are crucial steps towards advancing personalized medicine and narrowing the equity gap in healthcare. By acknowledging and accounting for these factors in sepsis management, clinicians can improve treatment outcomes and enhance patient care.
For more information, readers can refer to the original editorial by Helena Barrasa et al. in the Journal of Intensive Medicine. This groundbreaking research highlights the urgent need to bridge the equity gap in sepsis treatment by considering sex-related disparities in antibiotic dosing protocols.
