Antibiotic Guideline for the Empirical Treatment of Sepsis: 

• Sepsis is a systemic inflammatory response (SIRS) to infection and is considered present if there is a proven or highly suspected site of infection plus two or more of the following: 

• Severe sepsis is present if the above criteria are met plus there are signs of hypoperfusion or organ failures including low urine output, elevated urea or creatinine, abnormal LFTs, coagulation disturbance, hypoxia or ARDS, or a raised lactate 2mmol/L.

• Septic shock is where hypotension persists despite adequate fluid challenge, or requires use of vasopressors or inotropes.

TREATMENT    Take 2 sets of blood cultures (20 ml per set) +/- other samples as appropriate

Empirical 1st line treatment is based on the likely source of the bacteraemia

• No obvious source (sepsis of unknown origin) / MRSA a possibility
• IV-line associated sepsis
• Febrile neutropenia
• Urosepsis including Pyelonephritis.
• Respiratory tract - treat as Severe Pneumonia.
• Intra-abdominal/biliary sepsis
• Treatment of Endocarditis,..... for prophylaxis click here
• Cellulitis
• Bone and Joint
• Meningitis

Further sepsis information is available at http://intratemp/sepsis/index.htm

The full guideline "The Empirical Treatment of Sepsis in Adults" is available here

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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