The focus of infection is sometimes difficult to ascertain, but treatment must effectively target the responsible pathogen, from among a wide range of potentially etiologic agents [37] . Initial selection of an antimicrobial agent with good activity against the causative organism is crucial for survival. A prospective evaluation of sepsis [38] emphasized that, other than comorbidity, the factor most strongly associated with death was ineffectiveness of antimicrobial treatment against the micro-organism identified in blood cultures. Several large reports corroborated the relation between ineffective antibiotic treatment and poor prognosis. Consequently, broadspectrum antibiotics have been recommended, and the agent selected should provide coverage against the microorganisms that are usually involved in the suspected focus of infection [35] . Supportive clinical evidence for use of broadspectrum antibiotics will probably remain sparse [36] , but effective antimicrobial management requires good microbiologic sense.