Sepsis - Unknown Origin

First Line

Gentamicin IV as per protocol AND Amoxicillin 1g IV 8 hourly AND Metronidazole 500mg IV 8 hourly 

(if Staphylococcal infection suspected (eg IVDU) ADD Flucloxacillin 2g IV 6 hourly)

 

 

If concerns regarding nephrotoxicity e.g. acute kidney injury - replace Gentamicin with Temocillin IV dosed per Renal Drug Database

Penicillin Allergy

Vancomycin IV as per protocol AND Gentamicin IV as per protocol AND Metronidazole 500mg IV 8 hourly

If concerns regarding nephrotoxicity e.g. acute kidney injury - replace Gentamicin with Aztreonam IV dosed per Renal Drug Database

Notes

Send blood cultures  and other relevant samples

Check previous / recent microbiology results for guidance

Check previous MRSA status

 

Treatment duration: Guided by source of infection after investigation and clinical response. Refer to appropriate header in guidance. 

 

If there is treatment failure/relapse check microbiology results, seek senior clinical review +/- discuss with Microbiology consultant.