How is sepsis treated?

Sepsis and septic shock are medical emergencies. The S3 guideline "Sepsis - Prevention, Diagnosis, Therapy and Follow-up" therefore recommends starting therapy immediately.

Immediate therapy includes the administration of antibiotics and fluids via a venous catheter. In most cases, the first administration of antibiotics is calculated. In this case “calculated” means: Since the results of the microbiological tests are not yet available at this point, the drugs must be chosen to cover the pathogens suspected for the source of infection. As soon as the results are available and it is known which pathogen triggered the infection, this calculated initial therapy can be replaced by a therapy that is specifically adapted to the pathogen spectrum.

The medical team tries to eliminate the cause of the infection. This is called focal treatment. In addition to the administration of antibiotics, depending on the source of the infection, additional surgical sanitation may be necessary, e.g. in the case of an intestinal perforation.
Furthermore, the treatment aims to stabilise or, if necessary, support the individual organ functions. If respiratory function is impaired, this is done by administering oxygen or mechanical ventilation. Blood pressure must be raised with fluids and vasopressors. If kidney function is severely limited, dialysis may be necessary.

In the acute phase, an artificial coma, a long-term anaesthesia, is often necessary. For this, the patient receives medication as in anaesthesia during an operation - usually painkillers and sleeping pills.

Stabilisation of the organ functions is therefore central. But there is more to the treatment of sepsis patients: the prophylaxis of thromboses and stomach ulcers, (artificial) nutrition, the treatment of pain and more.