Sepsis (source unknown)

Sepsis

Common organisms

  • Broad — depends on source

Empirical therapy

  • Piperacillin-tazobactam 4.5 g IV q8h
  • Add Vancomycin if MRSA risk
  • Add antifungal if neutropenic / line sepsis

Culture-directed

  • Narrow within 48h based on cultures
Renal adjustment: Adjust each antibiotic individually.

Adverse effects

  • Multidrug toxicity
  • C. difficile

Monitoring

  • Lactate clearance, MAP ≥65
  • Daily review of source and de-escalation

Clinical pearls

  • Antibiotics within 1h of recognition
  • Take 2 sets of blood cultures before antibiotics

Educational support only — follow local antibiogram and institutional protocols.

WardRound

WardRound

Clinical Decisions in Seconds