Sex and Gender disparities in Sepsis Treatment Demand personalized Approaches
Sepsis remains a major cause of death in intensive care units globally. Despite improvements in detection and treatment, current standardized antibiotic dosing frequently enough fails to account for crucial patient-level variations, particularly those related to sex and gender, potentially leading to suboptimal outcomes.
A recent editorial in the Journal of Intensive Medicine authored by Dr. Helena Barrasa, Dr. Goiatz Balziskueta, and Professor Jordi Rello, emphasizes the critical role of biological and social factors in these disparities, specifically highlighting the potential for compromised outcomes for women. The authors argue for integrating sex and gender considerations into antimicrobial dosing protocols to address overlooked pharmacokinetic and pharmacodynamic differences.
The editorial points to the underrepresentation of women in clinical trials and the resulting increased risk of antibiotic overexposure. Factors like hormonal fluctuations,body composition,and renal clearance significantly impact drug processing,yet are frequently ignored in standard dosing algorithms.Conversely, younger men wiht higher renal clearance may receive insufficient doses, increasing the risk of treatment failure.
As the authors explain, “Standard dosing does not account for key biological differences. Women, due to impaired metabolism and lower muscle mass, are more vulnerable to adverse effects, while young men frequently enough eliminate medications too quickly to maintain therapeutic levels.”
Beyond these biological differences, societal gender roles and biases contribute to inequities in sepsis care. Women are demonstrably less likely to receive aggressive or timely interventions, potentially due to misinterpretation of their symptoms, differences in healthcare-seeking behavior, or implicit biases within emergency medical systems. These systemic inequalities exacerbate the biological factors already influencing drug response.
To address these challenges, the authors advocate for wider adoption of therapeutic drug monitoring to personalize treatment and minimize both toxicity and antibiotic resistance.Thay also urge the scientific community to prioritize sex and gender-informed research, noting that less than 30% of current studies report data stratified by sex.
Ultimately,as Professor Rello concludes,“Understanding differences shaped by sex and gender is essential to advancing personalized medicine and represents a commitment to closing the equity gap.” A more nuanced and individualized approach to sepsis treatment is crucial for improving outcomes for all patients.
