Medication Medication Septic treatment typically begins with antibiotics for the infection, which may be followed by medication to control blood pressure and other issues. “The major areas to focus on for the initial treatment of sepsis are to restore blood flow to vital organ systems and eliminate the inciting infection,” says Scott Weiss, MD , an associate professor of pediatrics at Thomas Jefferson University and the division chief of critical care medicine at Nemours Children’s Hospital in Wilmington, Delaware. Other medications may be given later in certain circumstances, including a proton pump inhibitor for those at risk of developing ulcers because of stress on the body, heparin for those at risk of deep vein thrombosis , and medications to control blood sugar levels .e60dc2a1-f33c-4a05-9b50-8e3e8e597629ff8ad449-fd98-4f08-bb3c-98e8ed1b2969 Antibiotics Although various organisms can cause an infection that turns into sepsis — such as bacteria, viruses, and fungi — bacteria is by far the most common cause, so the main treatment for sepsis typically is antibiotics.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291a6123f4-fddc-404a-80fb-a9c7c9ad77f1 You’ll receive antibiotics immediately after your doctor diagnoses sepsis, even when test results haven’t yet confirmed a bacterial infection. Ideally, you should receive antibiotics within the first three hours of diagnosis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ff8ad449-fd98-4f08-bb3c-98e8ed1b2969 Different antibiotics work better with certain types of bacteria. But because it takes time to identify which microbe is causing your infection, you’ll first receive a broad-spectrum antibiotic that can kill several types of bacteria. Later in your treatment, you may receive an antibiotic that’s targeted for the specific bacteria, and you may get an antifungal medication if a fungal infection is possible.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ff8ad449-fd98-4f08-bb3c-98e8ed1b2969 Doctors can treat sepsis with several antibiotics, depending on the cause of the underlying infection and issues such as an antibiotic-resistant infection.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f0962dc5-a940-451a-8203-c77b833bba8c Most belong to the β-lactam medication class, which are broad-spectrum antibiotics. Cephalosporins Derived from penicillin, this subclass of β-lactam antibiotics fights bacteria by targeting their cell wall. Examples include the following:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac501e7c-1578-4482-8cdf-67b53164076f cefepime (Maxipime) ceftazidime (Fortaz) ceftriaxone (Rocephin) Fluoroquinolones In use for around 40 years, this class of antibiotics targets bacteria’s DNA and includes these broad-spectrum examples:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac501e7c-1578-4482-8cdf-67b53164076f ciprofloxacin (Cipro) levofloxacin (Levaquin) Glycopeptides These broad-spectrum medications are often given to people who are infected with bacteria that’s become resistant to treatment from other antibiotics. The primary antibiotic from this class is vancomycin (Firvanq).e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac501e7c-1578-4482-8cdf-67b53164076f Penicillins The original antibiotic is still in use for people with sepsis. It belongs to the larger β-lactam class and works by blocking bacteria’s ability to synthesize cell walls.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac501e7c-1578-4482-8cdf-67b53164076f The primary penicillin medication used for sepsis is piperacillin, which is often combined with tazobactam, a related antibiotic (Zosyn is the brand name of this combination).e60dc2a1-f33c-4a05-9b50-8e3e8e597629f0962dc5-a940-451a-8203-c77b833bba8c Macrolides Introduced in 1952, macrolides block bacteria’s protein synthesis. They are especially good at treating respiratory infections that circulate in the community at large, rather than those in a hospital.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ac501e7c-1578-4482-8cdf-67b53164076f Azithromycin (Zithromax) is the primary macrolide used to treat sepsis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f0962dc5-a940-451a-8203-c77b833bba8c Nitroimidazoles These antibiotics stop bacteria from growing.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292ea11ebe-3c2f-43ca-addd-411d8772680f Metronidazole (Flagyl), the main member of this class used for sepsis treatment, is often combined with other antibiotics, particularly for infections related to the skin, soft tissues, and gastrointestinal and abdominal area.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f0962dc5-a940-451a-8203-c77b833bba8c If you have mild sepsis, you may receive a prescription for antibiotics to take at home. But if your condition progresses to severe sepsis, you will receive antibiotics intravenously in the hospital. This method helps the medicine get into your bloodstream quicker so it can fight the infection sooner. Antiviral Medications In some cases, a viral infection causes sepsis. If testing confirms this, your doctor may start you on an antiviral medication to help treat the underlying condition.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d43e246f-a3e2-41d0-af12-13dfbd94baa3 Not all viruses have targeted antiviral treatments. Antifungal Medications When a fungal infection causes sepsis, you will likely receive an intravenous antifungal drug.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b64869cf-05e8-4fe9-8bf3-d8d65984c875 Fungal infections that can turn into sepsis include a fungal bloodstream infection associated with catheters, a fungal infection in the gastrointestinal tract, a fungal infection in the lungs, and a fungal infection in the brain. Intravenous Fluids Even though sepsis is caused by an infection, antibiotics and other antimicrobials may not be enough to maintain a healthy blood pressure .e60dc2a1-f33c-4a05-9b50-8e3e8e5976290fcea921-a9f1-4ef2-823f-5546147001a8 Low blood pressure – a reading of 90/60 mmHg or lower for people who typically have normal blood pressure — can occur with severe sepsis and septic shock. To increase your pressure, you’ll need IV fluids while in the hospital.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290fcea921-a9f1-4ef2-823f-5546147001a8 Fluids help increase blood volume and prevent dehydration, which are two contributing factors to low blood pressure. Symptoms of too low pressure include shallow breathing, rapid pulse, clammy skin, and confusion. Treating low blood pressure is crucial because in this state, it becomes harder for blood to carry oxygen to different parts of the body. Organ damage can occur when your body doesn’t get enough oxygen. Various types of intravenous fluids can treat sepsis and increase blood volume. These include crystalloid fluids that contain minerals such as sodium (saline is an example). You may also receive colloids, which are thicker liquids, such as albumin.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290fcea921-a9f1-4ef2-823f-5546147001a8 Vasopressor Doctors may use another type of therapy when IV fluids are unable to increase blood pressure. Some people receive vasopressor medications, which constrict blood vessels to forcefully increase blood pressure. Norepinephrine is a first-line vasopressor for sepsis; epinephrine may be given later if needed.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294fd5ca0a-f210-4a5c-bf31-1c0bcabb4ce7 “For septic shock, vasopressors may be administered to maintain blood pressure within a safe range,” says Eleanor Erwin, MD , a board-certified emergency room physician with Williamsburg Emergency Physicians in Virginia. “Other medications may be tailored to the individual patient’s other medical problems.” Corticosteroids Corticosteroids target the inflammation that may stem from a maladaptive overreaction of your immune system. Medications such as hydrocortisone are sometimes given to people with septic shock who are taking higher doses of vasopressors, as corticosteroids can reduce the dosage of vasopressor that’s needed.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cb0ecf71-1dd2-41b7-85a0-9b32a2c36d9b
Other Treatments Other Treatments You may require other types of supportive therapy based on the extent of your condition. These therapies vary from person to person. Blood Transfusion People with sepsis may have a low number of red blood cells ( anemia ) and may need a blood transfusion while in the hospital. A red blood cell transfusion can be vital to help improve oxygen delivery throughout the body for those with anemia.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b12f65bc-c1e1-4a13-996f-63b7f2ba08d0 Dialysis As sepsis progresses, kidney damage can occur. If your kidneys stop functioning properly, you’ll need dialysis (also called renal replacement therapy) to help your kidneys filter blood and remove toxins from your body.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b700159a-d0dd-4a4c-a000-67224c60a4ce Hemodynamic Monitoring Septic shock can damage different organs, such as your heart and lungs. Your doctor may use hemodynamic monitoring to keep a close eye on your heart and lung function. This machine works by measuring the blood pressure in your veins, heart, and arteries, as well as the amount of oxygen in your blood.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d72d84df-42b2-42e7-b9a3-80a38d2e98a1 Hyperglycemia Treatment Some people with severe sepsis and septic shock also experience high blood sugar (hyperglycemia) . This risk applies to people with diabetes and those without diabetes. It is believed that a combination of stress and inflammation can induce insulin resistance and higher glucose levels. If so, you’ll usually receive insulin intravenously. Supplemental Oxygen Low blood pressure or acute respiratory distress syndrome (a type of respiratory failure in septic shock) may result in not enough oxygen reaching your organs. For that reason, some people with low blood oxygen levels are given extra oxygen.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c5447e25-111c-43dc-9298-0d2737dffa48 This therapy helps raise the amount of oxygen the lungs receive and subsequently the amount of oxygen that’s delivered to your blood. There are different ways to receive oxygen therapy, such as through a nasal tube, a face mask, or mechanical ventilation (inserting a tube into the trachea).
The Takeaway Sepsis is a serious, potentially life-threatening complication of an infection that requires prompt medical intervention to fight the underlying infection and treat any resulting issues, such as low blood pressure. Broad-spectrum antibiotics are typically the first-line treatment for sepsis and may be followed by targeted antimicrobials, intravenous fluids, vasopressors, or corticosteroids. Other sepsis treatments include surgery to remove infected or damaged tissue, blood transfusion, dialysis, hemodynamic monitoring, hyperglycemia medication, and supplemental oxygen. Up to half of those with sepsis develop postsepsis syndrome, with symptoms such as sleep issues, difficulty breathing, and repeated infections; these require ongoing care. Additional reporting by Sarah Shelton.
Sepsis is a rare complication of an infection for which there’s an extreme immune system response, triggering widespread inflammation throughout the body. It may be mild or severe, but because sepsis is a potentially life-threatening illness, it requires immediate medical attention.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c2b23d5d-632e-48ac-a634-e9a03383fde9 Symptoms of sepsis include a high fever , high heart rate, and fast breathing rate . As the infection progresses, some people experience difficulty breathing , stomach pain, confusion, and dizziness . Sepsis can lead to dangerously low blood pressure and organ failure (septic shock).e60dc2a1-f33c-4a05-9b50-8e3e8e597629c2b23d5d-632e-48ac-a634-e9a03383fde9 It’s important to seek treatment for sepsis right away, which may include medications and therapies to treat the underlying infection and other issues. Due to the gravity of this illness, sepsis isn’t something you treat at home. It requires an emergency room visit, followed by admission to the hospital with close monitoring and time-sensitive treatment.e60dc2a1-f33c-4a05-9b50-8e3e8e597629409f5586-fab6-4ed2-963e-b6bb6b2ee454 If you already have a sepsis diagnosis, talk to your healthcare provider about the best treatment for you, as well as before you stop or change your treatment.
Rehabilitation Rehabilitation and Therapy Long-term health issues are common in adults after sepsis. Up to half of those who get sepsis struggle with postsepsis syndrome, which has a myriad of symptoms that include problems sleeping, shortness of breath, muscle pain, and repeated infections. It can also cause depression , memory issues, and even nightmares.e60dc2a1-f33c-4a05-9b50-8e3e8e597629176cfe17-cd39-4d7d-9189-e3662c4d36b5 This is also common with kids who get sepsis. “Approximately one-third of children who survive sepsis will continue to struggle after hospital discharge,” says Dr. Weiss. “Common challenges include low physical endurance, decreased attention or ability to focus, anxiety, sleep problems, and emotional lability.” Your doctor can connect you with resources for ongoing support, such as counselors or physical therapists. “It’s important that families and pediatricians look for even subtle signs of lingering issues and seek help,” says Weiss. This is also important to prevent future infections. “Properly managing chronic medical problems that can compromise the immune system, such as controlling diabetes or chronic lung disease, is crucial for both avoiding and recovering from a sepsis infection,” says Dr. Erwin.
Surgery Surgery Once a doctor determines the source of the infection, surgery may be necessary to remove the infection as well as any infected or damaged tissues. For instance, you may need surgery or a similar treatment if you have an abscess, which is a pocket of pus usually caused by an infection.e60dc2a1-f33c-4a05-9b50-8e3e8e597629df03ae7a-2073-41d0-8868-8ada0312dde8 An abscess can form on the skin or inside the body as a complication of another infection. Some abscesses respond to antibiotics. But sometimes doctors must make an incision and drain an abscess or surgically remove an abscess to stop an infection.
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