Adult Sepsis / Septic Shock

Diagnostic Considerations

Some infections require source control:

  • Skin and soft tissue

  • Abscess

  • Intravascular lines

  • Pacemakers

  • Prosthetic Heart valves

  • Joint infections

  • If possible, obtain cultures prior to antibiotic administration; however, DO NOT DELAY ANTIBIOTICS FOR CULTURES

  • The sensitivity of blood cultures is significantly lower if collected after antibiotic administration

Urine culture if urinary symptoms

Sputum for culture if respiratory source suspected

  • CSF for meningitis/encephalitis

  • NP swab for influenza

Imaging as indicated by presentation

Treatment

Administer antibiotics WITHIN 1 HOUR of sepsis diagnosis

Consider recent antibiotic use (within 90 days) and previous colonization or infections with resistant microorganisms like Pseudomonas or MRSA that may change empiric management suggestions below.

Source control as indicated

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