TERMINOLOGY
CLINICAL CLARIFICATION
• Systemic illness due to microbial infection that can lead to acute organ dysfunction or failure and associated with host immune response to infection
CLASSIFICATION
• There is a disease continuum with increasing severity if not treated or not responsive to treatment o Systemic inflammatory response syndrome (SIRS)
- Documented or suspected infection with systemic manifestations of infection
- Clinical response to a nonspecific insult of either infectious or noninfectious (trauma, ischemia, inflammation) etiology
- Presence of SIRS plus documented or suspected infection is sepsis o Sepsis
- Documented or suspected infection with systemic manifestations of infection o Severe sepsis
- Sepsis plus acute organ …show more content…
May have hemoptysis
- If high suspicion, obtain imaging (CT angiogram orVQ scan) to confirm diagnosis o Diabetic …show more content…
• Mainstay of treatment is antimicrobials to treat infection and supportive care to prevent or treat acute organ failure 10
• Drug therapy o Antimicrobials
- Administration of effective intravenous broad-spectrum antimicrobials within three hours of time of presentation or within one hour of recognition of severe sepsis and septic shock
- Initiate empiric anti-infective therapy that have activity against all suspected pathogens (bacterial and/or fungal or viral) presumed to be the source of sepsis
- Reassess antimicrobial therapy daily for possible deescalation
- For patients with severe sepsis or septic shock and c Respiratory failure treat with an extended spectrum beta-lactam and either an aminoglycoside or fluoroquinolone to cover for Pseudomonas c Bacteremia treat with beta-lactam and macrolide for Streptococcus pneumoniae c Possible multi-drug resistant bacterial pathogens use combination therapy
- Empiric combination therapy should not be used for more than 3-5 days c Deescalate to the most appropriate single therapy as soon as susceptibility profile is known
- Typical duration of therapy is 7-10 days c Longer courses may be appropriate in patients with slow clinical response, bacteremia with Staph Aureus, or some viral or fungal
CLINICAL CLARIFICATION
• Systemic illness due to microbial infection that can lead to acute organ dysfunction or failure and associated with host immune response to infection
CLASSIFICATION
• There is a disease continuum with increasing severity if not treated or not responsive to treatment o Systemic inflammatory response syndrome (SIRS)
- Documented or suspected infection with systemic manifestations of infection
- Clinical response to a nonspecific insult of either infectious or noninfectious (trauma, ischemia, inflammation) etiology
- Presence of SIRS plus documented or suspected infection is sepsis o Sepsis
- Documented or suspected infection with systemic manifestations of infection o Severe sepsis
- Sepsis plus acute organ …show more content…
May have hemoptysis
- If high suspicion, obtain imaging (CT angiogram orVQ scan) to confirm diagnosis o Diabetic …show more content…
• Mainstay of treatment is antimicrobials to treat infection and supportive care to prevent or treat acute organ failure 10
• Drug therapy o Antimicrobials
- Administration of effective intravenous broad-spectrum antimicrobials within three hours of time of presentation or within one hour of recognition of severe sepsis and septic shock
- Initiate empiric anti-infective therapy that have activity against all suspected pathogens (bacterial and/or fungal or viral) presumed to be the source of sepsis
- Reassess antimicrobial therapy daily for possible deescalation
- For patients with severe sepsis or septic shock and c Respiratory failure treat with an extended spectrum beta-lactam and either an aminoglycoside or fluoroquinolone to cover for Pseudomonas c Bacteremia treat with beta-lactam and macrolide for Streptococcus pneumoniae c Possible multi-drug resistant bacterial pathogens use combination therapy
- Empiric combination therapy should not be used for more than 3-5 days c Deescalate to the most appropriate single therapy as soon as susceptibility profile is known
- Typical duration of therapy is 7-10 days c Longer courses may be appropriate in patients with slow clinical response, bacteremia with Staph Aureus, or some viral or fungal