LAUSR

Although overall mortality related to sepsis has been increasing due to the increased incidence of sepsis, the case-fatality rate has been decreasing over a similar period of time.1 During the last 20 years there has not been any scientific breakthrough in the sepsis field, thus, many of the recent improvements might be due to the performance improving program ‘‘Surviving Sepsis Campaign’’ (SSC).2 The initial aims of the SSC, which arose from the Declaration of Barcelona in October 2002, were to raise public and professional awareness of sepsis and its treatment, and the development of practice guidelines. In partnership with the Institute of Healthcare Improvement, key elements of the first edition guidelines published in 2004 were identified and organized in short treatment protocols called ‘‘bundles’’. A recent update was published in 2013 with removal of the 24-hour bundle and changes in recommendations for fluids and vasopressor administration based on recent scientific evidence. In Spain, a wide national educational program based on the SSC guidelines (Edusepsis study) was launched in 2006. It was associated with improved guideline compliance and lower hospital mortality.3 In 2011 a second education program was launched to promote the early use of antibiotics (ABISS-Edusepsis study). In this issue of Medicina Intensiva Sánchez and colleagues4 analyze the evolution of sepsis-related mortality