Severe Sepsis - Unknown Focus (Antimicrobial)
TAM (Treatments and Medicines) NHS Highland
Seek microbiology advice. Review regime regularly in light of evolving clinical picture.
Review within 24 hours to confirm diagnosis, then follow appropriate infection specific recommendations.
If sepsis has a cutaneous component or is arising from the skin, REFER TO SECTION ON NECROTISING FASCIITIS (under skin/soft tissue infections).
Drug details
Community-acquired infection
IV amoxicillin 1g every 6 hours PLUS IV gentamicin - refer to NHS Highland gentamicin dosing guidelines PLUS IV metronidazole 500mg every 8 hours.
Duration - according to diagnosis.
If Staphylococcus aureus infection suspected
ADD IV flucloxacillin 2g every 6 hours
Duration - according to diagnosis.
In penicillin allergy, severe renal impairment, acute kidney injury or hospital-acquired infection
IV aztreonam 2g every 6 hours PLUS IV vancomycin - refer to NHS Highland vancomycin dosing guidelines PLUS IV metronidazole 500mg every 8 hours
Duration - according to diagnosis.