Treatment

Like we have already mentioned, the severe sepsis is characterized by stimulation of a series of inflammatory cascades leading to extensive cardiovascular problems and the most obvious signs are hypotension due to vasoplegia, relative hypovolemia, and widespread dysfunction of the microvasculature. That’s why; the two major priorities in management of septic patients are

 

Most experts say that septic shock should be treated initially with a combination of antibiotics and fluid replacement. Why? Well, it is logical to assume that the antibiotic is chosen based on the bacteria present, although two or more types of antibiotics may be used initially until the organism is identified and these fluids, which should be administrated intravenously, should replace the fluid lost by leakage. Coagulation and hemorrhage may be treated with transfusions of plasma or platelets.  

Pneumonia

Second- or third-generation cephalosporin plus macrolide (antipseudomonal beta lactam plus aminoglycoside if hospital-acquired)

Urinary tract

Ampicillin plus gentamicin (Garamycin) or third-generation cephalosporin

Skin or soft tissue

Nafcillin sodium (Nafcil, Nallpen, Unipen) (add metronidazole [Flagyl, Metro IV, Protostat] or clindamycin if anaerobic infection suspected)

Meningitis

Third-generation cephalosporin

Intra-abdominal

Third-generation cephalosporin plus metronidazole or clindamycin

Primary bacteremia

Ticarcillin and clavulanate potassium (Timentin) or piperacillin sodium and tazobactam sodium (Zosyn)

 

Significant complications from sepsis include:

·          central nervous system dysfunction

·          adult respiratory distress syndrome (ARDS)

·           liver failure

·          acute renal failure (ARF

·          disseminated intravascular coagulation (DIC)

 

Every patient should know that the chanced for recovery from septic shock depend on several factors and the most important including:

·          the degree of immuno-suppression of the patient

·          underlying disease

·          promptness of treatment,

·          Type of bacteria responsible.

Like we have already mentioned- several researches done in the past have shown that septic shock is most likely to develop in the hospital, since it follows infections which are the primary form of this condition. That’s why; in order to prevent this it is crucial to know that careful monitoring and early, aggressive therapy can minimize the possible likelihood of progression. It is logical to assume that the risk of developing septic shock can be minimized through treatment of underlying bacterial infections, and prompt attention to signs of bacteremia.