McMaster Textbook of Internal Medicine

McMaster Textbook of Internal Medicine
Interviews
ICU & Emergencies
First-line antibiotics in sepsis of unknown origin

First-line antibiotics in sepsis of unknown origin

2018-09-18

Emilie Belley-Côté

Recorded at the 4th McMaster International Review Course in Internal Medicine (MIRCIM).

What are the first-line antibiotics in sepsis of unknown origin?

Emilie Belley-Côté, MD: I tend to go with a broad-spectrum antibiotic that has gram-positive and gram-negative coverage, such as Tazocin—piperacillin/tazobactam. If the patients are quite sick, I will add vancomycin.

That being said, if the patient has been in hospital for more than 48 hours, has been exposed to broad-spectrum antibiotics in the past, or is known to have had in the past an infection with an extended-spectrum beta-lactamase (ESBL)–producing bacteria, then I will go with a carbapenem as first-line coverage instead.

See also

Antacids and the risk of traveler’s diarrhea Do antacids affect the risk of traveler’s diarrhea?
EMS and rheumatologic emergencies What should emergency medical services (EMS) pay special attention to in terms of rheumatologic emergencies?
Sepsis: No response to the initial fluid bolus How to manage a patient with sepsis not responding to the initial intravenous (IV) fluid bolus?
PoCUS and volume status examination What is the best way to assess volume status?
Update on the management of septic shock A lecture by Dr Waleed Alhazzani, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2017.
Antibiotic resistance: how to handle in clinical practice A lecture by Prof. Mark Loeb, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2016.
SSC 2016. Part 1: Methodology. Principles of resuscitation Prof. Waleed Alhazzani, one of the lead authors of Surviving Sepsis Campaign guidelines, gives us an insider’s view on SSC methodology and discusses main points concerning resuscitation.
Surviving Sepsis Campaign 2016 guidelines A lecture by Prof. Andrew Rhodes delivered at the conference Challenges and Opportunities in Caring for Critically Ill in Kraków in 2016.

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