Severe Sepsis and Septic Shock of Unknown Source

Severe Sepsis and Septic Shock of Unknown Source


Empiric antibiotic regimens for patients with sepsis syndromes will typically be guided by the suspected infectious focus or source and can be found throughout the guidelines on Firstline; should a patient have an unknown source, broad antibiotic coverage is warranted as below

  • The Surviving Sepsis Campaign 2016 recommends antibiotic initiation with 1 hour of sepsis or septic shock
  • CMS Core Measures report the metric of antibiotics started within 24 prior to and 3 hours following severe sepsis as appropriate
  • Is recommended initially for septic shock cases
  • This coverage should be provided with the commitment to de-escalate with discontinuation of double-coverage within the first few days in response to clinical improvement
    • This applies to both targeted and empiric double-coverage

Empiric Treatment: Unknown Source


7 to 10 days is adequate for most serious infections associated with sepsis and septic shock

Consider discontinuation or de-escalation of antibiotics after 72 hours of empiric coverage in the absence of a clear source of infection