Sepsis of Unknown Source and Systemically Unwell (H@H)

Length of treatment: 5 days

Investigations:

Send blood cultures

If patient has urinary symptoms or febrile and unable to give a history send urine for culture where possible

If patient has respiratory symptoms consider a viral throat swab

Amoxicillin 1g orally every 8 hours

PLUS

Gentamicin intravenous as per NHS Lothian online calculator

PLUS

Metronidazole 400mg orally every 8 hours only if concerns regarding intra-abdominal

source of infection.

 

OR (Penicillin allergy)

Co-trimoxazole 960mg orally every 12 hours

(see Appendix 1) for dose reduction in renal impairment)

PLUS

Gentamicin intravenous as per NHS Lothian online calculator

PLUS

Metronidazole 400mg orally every 8 hours only if concerns regarding intra-abdominal

source of infection.

 

If after 48 hours the patient is responding and no positive culture results complete treatment with either amoxicillin or co-trimoxazole.

If patient is not responding then discuss with MoE/consultant from H@H service in the first instance, then seek advice from an infection specialist and consider whether continuation of antibiotics is appropriate