Sepsis

Sepsis is the systemic response to infection, usually caused by bacterial infections (both Gram positive and Gram negative). It is a common condition with an overall mortality of about 30%, even when treated appropriately. It can be difficult to recognize at the early stages. Sepsis and septic shock are characterised by multiorgan failure, in the main caused by a dysregulated immune response to the infection. Effective management depends on early initiation of treatment. All patients should receive oxygen and fluids. Most will require vasopressor. Pus should be drained. Antibiotics need to be given as quickly as possible and will usually be a broad spectrum, bearing in mind the likely causative organisms and the possibility of antimicrobial resistance. Patients satisfying NICE criteria should be given drotrecogin alfa (activated).