Treating sepsis

Treatment for sepsis varies, depending on the site and cause of the initial infection, the organs affected and the extent of any damage.

You'll usually be referred to hospital for diagnosis and treatment if you have possible early signs of sepsis. Severe sepsis and septic shock are medical emergencies.

Management of sepsis after admission to hospital usually involves three treatments and three tests, known as the "sepsis six". These should be initiated by the medical team within an hour of diagnosis.

Treatment involves:

• giving Penicillin if the sepsis is detected early enough, this may bea course of tablets you can finish taking athome
• giving fluids intravenously
• giving oxygen if levels are low

These treatments are described in more detail below.

Tests will include:

• taking blood culturesto identify the type of bacteria causing sepsis
• taking a blood sampleto assess the severity of sepsis
• monitoring your urine outputto assess severity and kidney function

Emergency treatment

You'll need emergency hospital treatment and may require admission to an intensive care unit (ICU) if:

• the sepsis is severe
• you develop septic shock when your blood pressure drops to a dangerously low level

ICUs are able to support any affected body functions, such as breathing or blood circulation, while the medical staff focus on treating the infection.

Because ofproblems with vital organs, people with severe sepsis are likely to be very ill. Up to 4 in every 10 people with the condition will die.

Septic shock is even more serious, with an estimated 6 in every 10 cases proving fatal.

However, sepsis is treatableif it isidentified and treated quickly, and in most cases leads to full recovery with no lasting problems.

Antibiotics

The main treatment for sepsis, severe sepsis or septic shock is antibiotics .

If you have severe sepsis and septic shock, antibiotics will be given directly into a vein (intravenously).

Ideally, antibiotic treatment should start within an hour of diagnosis to reduce the risk of serious complications or death.

Intravenous antibiotics areusuallyreplaced bytablets aftertwo to four days.You may have to take themfor 7 to 10 days or longer, depending on the severity of your condition.

Types of antibiotics

There won't usually be time to wait until a specific type of infection has been identified, so broad-spectrum antibioticsare given first.

These are designed to work against a wide range of known infectious bacteria and usually cure most common infections.

Once a specific bacterium has been identified, a more focused antibiotic can be used.

Viral infections

If the sepsis is caused by a virus, antibiotics won't work. Antibioticsare usuallygiven anyway because it would be too dangerous to delay treatment until tests confirm the specific cause.

With a viral infection, you'll need to wait until your immune system starts to tackle the infection, although antiviral medication may be given in some cases.

Intravenous fluids

If you have sepsis, your body needs increased amounts of fluid to prevent dehydration and kidney failure.

You'll usually be given fluids intravenously during the first 24 to 48 hours after admission if you have severe sepsis or septic shock.

It's important that the doctors know how much urine your kidneys are making when you have sepsis so they can spot signs of kidney failure.

If you're admitted with severe sepsis or septic shock, you'll usually have a catheter inserted into your bladder to monitor your urine output.

Oxygen

Your body's oxygen demand goes up if you have sepsis.

If you're admitted to hospital with sepsis and the level of oxygen in your blood is low, you'll usually be given oxygen. This iseither giventhrough a mask or tubes in your nostrils.

Treating the source of infection

If a source of the infection can be identified, such as an abscess or infected wound,this will also need to be treated.

For example, any pus may need to be drained away or, in more serious cases, surgery may be needed to remove the infected tissue and repair any damage.

Increasing blood pressure

Medications called vasopressors are used if you have low blood pressure caused by sepsis.

Vasopressors are normally given intravenously while you're in an ICU. Extra fluids may also be given intravenously to help increase blood pressure.

Other treatments

You may also require additional treatments, such as:

• corticosteroids or insulin medication
• a blood transfusion
• mechanical ventilationwhere a machine is used to help you breathe
• dialysis where a machine filters your blood to copy the function of your kidneys

These treatmentsare mostly used in ICUs.