What is the treatment for sepsis?
In almost every case of sepsis, patients need to be hospitalized, treated with appropriate intravenous antibiotics, and given therapy to support any organ dysfunction. Sepsis can quickly cause organ damage and death; therapy should not be delayed as statistics suggest as high as a 7% mortality increase per hour if antibiotics are delayed in severe sepsis. Most cases of sepsis are treated in an intensive care unit (ICU) of the hospital by critical care medicine specialists, infectious disease specialists, and others as needed.
Appropriate antibiotics to treat sepsis are combinations of two or three antibiotics given at the same time; most combinations usually include vancomycin to treat many MRSA infections. Some of the commonly used antibiotics used are
- ceftriaxone (Rocephin),
- meropenem (Merrem),
- ceftazidime (Fortaz),
- cefotaxime (Claforan),
- cefepime (Maxipime),
- piperacillin and tazobactam (Zosyn),
- ampicillin and sulbactam (Unasyn),
- imipenem/cilastatin (Primaxin),
- levofloxacin (Levaquin), and
- clindamycin (Cleocin).
However, once the infecting organism is isolated, labs can determine which antibiotics are most effective against the organisms, and those antibiotics should be used to treat the patient. In addition to antibiotics, two other major therapeutic interventions, organ-system support and surgery, may be needed. First, if an organ system needs support, the intensive care unit can often provide it (for example, intubation [mechanical ventilation] to support lung function or dialysis to support kidney function) or a central venous catheter and fluid replacement with intravenous fluids and/or antihypotensive medication to raise blood pressure (norepinephrine [Levophed] or phenylephrine [Neo-Synephrine] administered by IV). Secondly, surgery may be needed to drain or remove the source of infection. Amputation of extremities has been done to save some patients' lives.