Sepsis of Unknown Source

Initial Empiric Antimicrobial Therapy


  • If allergy to penicillin or if known/suspected infection with a multi-drug resistant Gram-negative organism (i.e. ESBL or AmpC producing)

If MRSA risk factors, then ADD:

  • Target trough: 10 to 15 mg/L

  • Consider capping the loading dose at a maximum of 3,000 mg and maintenance doses at a maximum of 2,000 mg.

  • Dose adjustment required in renal dysfunction.

  • History of MRSA infection or colonization

  • Household contact with a MRSA colonized individual

  • IV drug use

  • Homelessness

  • Incarcerated persons

  • Recent travel to or residing in an MRSA endemic region or community

Additional Information

Dose adjustment require in renal impairment for all above antimicrobials.

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