(
>= 2 of T > 38.5 deg C or < 35 deg C, tachycardia, tachypnea,
WBC > 12,000 or < 4,000 or 10% bands); Sever sepsis is associated
with organ dysfunction, lactic acidosis, hypotension, decreased
urine output, altered mental status, or hypovolemia. Other signs
- fever, chills, hypoxemia, ARDS, low SVR, DIC, ARF/ATN, abnormal
LFT's
Rx: Abdomen/Pelvis - Ampicillin + Gentamycin/AG
(aminoglycosides) + Flagyl [triples]; unasyn or Zosyn + AG; Mild
Intra-abdominal - Cefoxitin; Cefotetan; Unasyn; Clindamycin
+ AG (Gentamycin); Urinary - Ampicillin + AG; 3rd Generation
Cephalosporin + AG; Pediatric Petechial Rash - Ceftriaxone;
Cefotaxime; Adult Petechial Rash 3rd Generation Cephalosporin
+ AG
Immunocompromised Timentin or Zosyn + AG +?Vancomycin; Ceftriaxone
+ Amikacin; Imipenim; Ceftazidime + AG + ?Vancomycin; IVDA
- PCN + AG + Nafcillin; Vancomycin + AG; Note -
Aztreonam can substitute for AG's when concerned for renal toxicity
Always consider Vancomycin (covering MRSA) with possible catheter
related sepsis. Always optimize oxygenation, hemodynamic profiles
and urine output. Panculture patient.
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