S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025
Abstract
Background: Sepsis is an acute, life-threatening multiple organ dysfunction triggered by an infection.
Methods: This guideline is an update of the S3 guideline "Sepsis-prevention, diagnosis, therapy, and follow-up care" (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaft [AMWF] Registry No. 079-001) of the German Sepsis Society (DSG) dated 31 December 2018. The update of the "Surviving sepsis campaign (SSC): international guidelines for management of sepsis and septic shock 2021" dated 4 October 2021, was used as the reference guideline. The DSG Guideline Commission compared each recommendation on the underlying PICO questions of the DSG Guideline 2018 (literature search until December 2018) with those of the SSC Guideline 2021 (literature search until July 2019) and evaluated the newly available published data (literature search until December 2024) by means of systematic update searches and literature reviews in compliance with the rules of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system and the AWMF.
Results: A total of 88 PICO questions were addressed, including those related to the diagnosis and treatment of infection and organ failure. Of these, two were agreed upon as statements, 29 as expert consensus, and 57 as evidence-based recommendations (26 with a strong and 31 with a weak recommendation grade). Compared to the previous 2018 guideline, 43 recommendations were reviewed but retained, 16 recommendations…
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