Spectrum: Local Antimicrobial Stewardship, for Bakersfield Memorial Hospital

Empiric Treatment: Source Unclear

  • In sepsis, timing of ABX is crucial.

  • Every hour delay of ABX increases the patient risk of mortality approximately 10%.

  • The first dose of ABX should be administered within 1 hour from the time of presentation.

For proper bundle compliance, use the physician Sepsis Order Set in Cerner.

Empiric Therapy

Zosyn 3.375 g IV every 8 hr (4 hr infusion)

OR

Cefepeime 2 g IV every 8 hr

PLUS

Vancomycin

Severe Beta-Lactam Allergy

Vancomycin

PLUS

Aztreonam 2 g IV every 8 hr

Duration

Broad spectrum empiric therapy is only appropriate while cultures are pending i.e. first 48-72 hours

Vancomycin should almost always be stopped if no resistant Gram-positive organsims are recovered in cultures.