| Infection |
| Sepsis without localising signs (non-pregnant adults) |
| Antibiotic Therapy (before prescribing, carefully read the Notes / Comments section below) |
|
See treatment overview below: Patients with acute or chronic impairment of renal function and an eGFR <20ml/min and those with decompensated alcoholic liver disease are at increased risk of adverse events with gentamicin. IV temocillin (see here for dosing guidance) is a beta-lactam antimicrobial with a comparable breadth of gram negative cover which can replace gentamicin in these patient populations, provided they do not have a history of penicillin allergy. However, temocillin does not cover P. aeruginosa. Review gentamicin at 72 hours. See the 'IV Gentamicin Review after 72 hours of Treatment' algorithm (N.B. links within the document are only active if accessing via NHS network). Gentamicin must not be administered to patients with myasthenia gravis as it can precipitate a myasthenic crisis. If the use of gentamicin is contraindicated, the agent should not simply be omitted, but an alternative regimen should be chosen. |
| Duration |
| Dependent on the source of sepsis |
| Notes / Comments |
|
A diagnosis of sepsis requires both clinical or laboratory evidence of an infective focus AND physiological derangement in keeping with sepsis (NEWS/MEWS score or SOFA score based). Send up to three sets of blood cultures before starting antimicrobial therapy. Review response to antimicrobial therapy daily. Adjust treatment as soon as the source of infection is identified, taking microbiology culture and sensitivity results into account. The management of sepsis without localising signs in pregnancy should be discussed with an infection specialist. |
Page last updated: August 2025