From the Research
The typical inpatient treatment duration for sepsis is 7 to 14 days, as supported by the most recent study from 2023 1. This duration can vary significantly based on the patient's response to therapy, the source of infection, and the specific pathogen involved. Initial treatment begins with broad-spectrum antibiotics such as piperacillin-tazobactam, meropenem, or a combination of vancomycin plus cefepime, administered intravenously. These antibiotics should be started within one hour of sepsis recognition, as emphasized in the 2021 study 2. Fluid resuscitation with crystalloids (typically 30 ml/kg) is also crucial in the first hours. Once culture results return (usually within 48-72 hours), antibiotics should be narrowed to target the specific organism. Vasopressors like norepinephrine may be needed if hypotension persists despite fluid resuscitation. Source control, such as draining abscesses or removing infected devices, is essential when applicable, as highlighted in the 2019 study 3. Patients typically remain hospitalized until they are hemodynamically stable, afebrile for at least 24-48 hours, laboratory markers are improving, and they can tolerate oral medications if continuing antibiotics as an outpatient. Some complicated cases may require longer hospitalization or specialized care, particularly with resistant organisms or in immunocompromised patients, as noted in the 2018 study 4 and the 2011 study 5. Key considerations in sepsis management include:
- Early recognition and treatment
- Broad-spectrum antibiotics
- Fluid resuscitation
- Source control
- Vasopressor support when needed
- Monitoring for complications and adjusting treatment accordingly. The 2023 study 1 provides the most recent and highest quality evidence for the treatment of sepsis, supporting the use of meropenem or piperacillin-tazobactam for 7 to 14 days.