本試驗目的為確認某醫學中心內科加護病房，嚴重敗血症與敗血性休克盛行率 及該族群病患特徵，且評估由藥師輔助實踐嚴重敗血症與敗血性休克治療指引對病 患預後影響。
自 2006  年 2 至 7 月於某醫學中心內科加護病房進行前瞻性、介入性試驗。共 篩選  342  位病患，其中 62 位符合標準納入試驗。納入後計算簡化急症生理分數（the simplified acute physiology score; SAPS II）及連續器官衰竭評估（the sequential organ failure assessment; SOFA）分數。收集流行病學、疾病、臨床與實驗室數據。總加護病房死亡率為 35%，平均 SAPS II 與 SOFA 分數分別為 69.5  ± 14.7  與 9.4 ± 3.7 分。病患最常受感染部位為肺部（33.3%）與泌尿道（29.5%）。血液培養陽性率為 24.2%。 各項品質指標成效為，量測血中乳酸鹽濃度（46.7%）、投與抗生素前進行血液培養（96.7%）、早期投與抗生素（100.0%）、足夠輸液復甦（87.0%）、達到中央靜脈壓力目標（88.7%）、投與低劑量類固醇（24.3%）與血糖控制（35.5%）。試驗期間藥 師共介入 88 次，主要為調整藥物劑量（19.3%）與選擇替代藥物（14.7%）。本試驗 中，SAPS II 分數、器官衰竭數目及敗血性休克為加護病房死亡率重要之預後指標。 藥師輔助實踐嚴重敗血症與敗血性休克治療指引是可行的。藥師於低劑量類固醇用藥評估、調整藥物劑量，及改善血管收縮劑或強心劑使用扮演重要角色。
 

The aim of the study was to define the incidence of severe sepsis and septic shock and the  characteristics of critical ill patients in a medical intensive care unit  (ICU). The study also assessed the feasibility of the implementation of evidence-based guidelines for the management of severe sepsis and  septic shock in this cohort.
A prospective, interventional study was conducted from February 2006  to July 2006 in a multidisciplinary twelve-bed medical ICU of a medical center. Sixty-two consecutive patients fulfilling criteria for the diagnosis of severe sepsis and septic shock were  included.
The simplified acute physiology score (SAPS II) and the sequential organ failure assessment (SOFA) score were calculated when patients were included. Demographic data, comorbid diseases, clinical and laboratory data were collected prospectively by a preprinted case report form. The overall ICU mortality was 35%. The mean SAPS II and initial SOFA score were 69.5  ± 14.7 and 9.4 ± 3.7,respectively. In patients with severe sepsis and septic shock, the lung was the most common site of infection (33.3%), followed by the urinary tract (29.5%). Blood culture was  positive in 24.2% of patients in this  cohort. With  implementation of the sepsis resuscitation and management bundles, lactate level was measured in 46.7% of the patients, and antibiotics were administrated before culture in 96.7% of patients, broad-spectrum antibiotics were given within 3 hrs after severe sepsis or septic shock was identified in 100.0% of patients. Adequate fluid challenge and  goal of central venous pressure (CVP) were achieved in 87.0% and  88.7% of patients, respectively. Low-dose steroid was administrated either intermittently or continuously in 14.5% of patient (24.3% of  patient with septic shock). Only 35.5% of patients reached the  goal of blood sugar control. During study, a total of 88 pharmacist interventions were recorded. Of these, 17(19.3%) were related to dosage adjustment and 13 (14.7%) were related to recommendation of alternative therapy. In this  study, SAPS II, organ failure number and  sepsis type (severe sepsis or septic shock) were important prognostic variables for ICU mortality.