Spectrum: Local Antimicrobial Stewardship, for Fraser Health

Sepsis - Hospital Onset

Note

Empiric antibiotics should be reassessed after 48 hours in light of clinical progress, investigations, and microbiology results.

Considerations

MRSA Risk Factors

  • Prior MRSA colonization/infection

  • Intravascular or urinary catheter

  • Prolonged hospitalization

  • Recent broad-spectrum antibiotic exposure.

ESBL Risk Factors

  • Prior ESBL colonization/infection

  • Recent broad-spectrum antibiotic exposure

  • Recent travel.

Penicillin Allergy

The risk of serious cross-reaction in penicillin/cephalosporin allergic patients given carbapenems is very low.

In most patients with sepsis or septic shock, the potential benefits of carbapenem therapy outweigh the low risk of anaphylaxis.

Empiric Treatment Guidelines Based On Source

Unknown Source

Febrile Neutropenia

Intra-Abdominal or Hepatobiliary

Pneumonia

Urinary Tract

Wound Infection

Definitions

SIRS

POTENTIAL SEPSIS without life-threatening organ dysfunction

SEPSIS with life-threatening organ dysfunction

SEPTIC SHOCK

References
  1. Singer M. et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016;315:801-810.
  2. Surviving Sepsis Campaign. Surviving Sepsis Campaign Response to Sepsis-3. March 2016. http://www.survivingsepsis.org/
  3. BC Sepsis Network. BC Sepsis Network special communication on the third international consensus defintions for sepsis and septic shock (Sepsis-3). April 2016. https://bcpsqc.ca/documents/2012/09/SepsisLetter.pdf