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.
- giving antibiotics – if the sepsis is detected early enough, this may be a course of tablets you can finish taking at home
- giving fluids intravenously
- giving oxygen if levels are low
These treatments are described in more detail below.
Tests will include:
- taking blood cultures – to identify the type of bacteria causing sepsis
- taking a blood sample – to assess the severity of sepsis
- monitoring your urine output – to assess severity and kidney function
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.
Due to problems with vital organs, people with severe sepsis are likely to be very ill and 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, if identified and treated quickly, sepsis is treatable, and in most cases leads to full recovery with no lasting problems.
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 are usually replaced by tablets usually after 2 to 4 days. You may have to take them for 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" antibiotics are 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.
If the sepsis is caused by a virus, antibiotics won't work. Antibiotics are usually given 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.
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 24-48 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.
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 is either given through 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.
You may also require additional treatments, such as:
- corticosteroids or insulin medication
- a blood transfusion
- mechanical ventilation (where a machine is used to help you breathe)
- dialysis (where a machine filters your blood to copy the function of your kidneys)
These treatments are mostly used in ICUs.