Last reviewed January 2021
Last reviewed January 2021
Last reviewed January 2021
Sepsis Origin | Empiric Initial Intravenous Antibiotic | |
---|---|---|
Unknown | ||
*Piperacillin/tazobactam 4.5 g IV ADD Vancomycin 25 mg/kg IV if MRSA risk factors |
||
Lung (pneumonia) | ||
Community Acquired | Ceftriaxone 1 g IV and Azithromycin 500 mg IV OR Levofloxacin 750 mg IV |
|
Hospital Acquired | *Piperacillin/tazobactam 4.5 g IV | |
ADD Vancomycin 25 mg/kg IV if MRSA risk factors | ||
Intra-abdominal | ||
Community Acquired | Ceftriaxone 1 g IV and Metronidazole 500 mg IV | |
Hospital Acquired | *Piperacillin/tazobactam 3.375 g IV (if confirmed or suspected Pseudomonas use 4.5 g IV q6h) | |
Urological | ||
Community Acquired | Ceftriaxone 1 g IV | |
Hospital Acquired | *Piperacillin/tazobactam 3.375 g IV (if confirmed or suspected Pseudomonas use 4.5 g IV q6h) | |
Rapidly progressing/necrotizing fasciitis skin infection | ||
*Piperacillin/tazobactam 3.375 g IV and Clindamycin 900 mg IV ADD Vancomycin 25 mg/kg IV if MRSA risk factors |
||
Central nervous system | ||
Acute community acquired meningitis | Dexamethasone 10 mg IV before 1st antibiotic Ceftriaxone 2g IV and Vancomycin 25 mg/kg IV ADD Ampicillin 2 g IV for Listeria coverage if age greater than 50 or risk factors (excessive alcohol consumption, pregnant, immunocompromised) |
|
* Initiate meropenem 500 mg IV instead of piperacillin/tazobactam if history of anaphylaxis to any penicillin antibiotic (e.g.. penicillin, cloxacillin, etc.). Avoid meropenem if history of severe delayed skin reaction/organ dysfunction (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and system symptoms, etc.) to any beta-lactam antimicrobial. Refer to NSHA beta-lactam allergy document for more information. |
Last reviewed January 2021
1. Singer M et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810. https://jamanetwork.com/journals/jama/fullarticle/2492881
Last reviewed January 2021