CONCLUSION
In this study, we firstly demonstrated that de-escalation therapy played a novel immunomodulatory effect during sepsis, which was depended on the NET formation. The early use of NET-promoting antibiotics (maximizing the capacity of capturing bacteria) in the early stage, followed by NET-inhibiting antibiotics in the late stage (preventing NET-associated organ injury), may be a reasonable treatment algorithm for the treatment of sepsis. Our study may shed lights on immunotherapy treatment in sepsis that involves the detection of NETs and usher the treatment of sepsis into the era of precision medicine and individualized therapy.