Sepsis - Hospital Onset

NOTE

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

Considerations

  • Prior MRSA colonization/infection

  • Intravascular or urinary catheter

  • Prolonged hospitalization

  • Recent broad-spectrum antibiotic exposure.

  • Prior ESBL colonization/infection

  • Recent broad-spectrum antibiotic exposure

  • Recent travel.

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.

  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