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Sepsis drug fights infection, decreases hospital care over two year study

A study in the July 15 issue of the journal "Clinical Infectious Diseases" shows that people 75 and older who were treated for severe sepsis with the drug drotrecogin alpha activated (DAA) had markedly higher survival rates, spent less time on ventilators and in intensive care units and had no more risk of side effects than their younger counterparts -- patients 65 to 74 -- treated with the same drug.

Unfortunately, the study author, Dr. Wes Ely of Vanderbilt University Medical Center, says the drug is highly underutilized. "Conservatively, I would say that fewer than one in four of the older patients who are candidates for this potentially life-saving drug actually receive it," said Ely, associate professor of allergy, pulmonary and critical care medicine and the director of research for the Geriatric Research Education and Clinical Center (GRECC) for the VA Tennessee Valley Health Care System.

The study raises concerns about an age bias in medicine. "The medical community as a whole hasn't fully embraced this type of medical therapy for severe sepsis because of concerns about resource use and safety in older patients and questions about their subsequent quality of life," Ely said. "On one hand some older patients receive overly aggressive life support without benefit, but in the case of this new drug, physicians seem to practice ageism and don't use the available therapy to patients' full advantage.

"When patients are relatively healthy and active, we should take age out of the medical equation. Older patients need research specific to their outcomes and they need advocates," he said.

More than 2,000 people are diagnosed with severe sepsis every day, and this disease kills as many people as heart attacks -- 750 each day in the United States.. The problem continues to grow as the population ages. More than half of all ICU days are occupied by people 65 and older; the number of days per year spent in an ICU are seven-times greater for people
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Contact: Clinton Colmenares
clinton.colmenares@vanderbilt.edu
615-322-4747
Vanderbilt University Medical Center
9-Jul-2003


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