Page 36 - HPP ANTIMICROBIAL GUIDELINE 2018

SEPSIS

NEW SEPSIS-3 DEFINITION

SEPSIS SEPSIS WITH PERSISTENT HYPOTENSION
- Life threatening organ dysfunction caused by a - Requiring vasopressor to maintain MAP≥ 65mmHg and
dysregulated host response to infection - Serum lactate level > 2 mmol/L despite adequate fluid
- Suspected & documented infection and resuscitation

- Acute increase of ≥ 2 SOFA (or *qSOFA) points - Hospital mortality > 40%.
- Hospital mortality >10%

1. If a diagnosis of sepsis has been made, then it is a MUST to search for the source of sepsis.
2. Complete history taking and careful clinical examination need to be done.
3. Septic screen
a. Take 2 sets of peripheral blood cultures.
b. Other microbiological specimens if indicated e.g. joint aspirates, sputum, etc.
c. Radiological examinations are essential.
4. Review past microbiological results, especially multidrug resistant organisms (MDRO) eg. MRSA, ESBL Gram Negative, CRE etc.
5. If a source is identified, refer to the specific guidance for antimicrobial therapy for that body site.
6. If no source of infection is evident, refer to the treatment algorithm in the next page.

*qSOFA score calculation – refer to appendix 5.

HPP AMG Sepsis 13