Sepsis

Signs and symptoms

Severe illness: fever (can be absent, especially in children); fast heart rate; fast breathing

Investigations

+/- Malaria parasites; do not rule out sepsis if malaria parasites are seen; blood culture for culture and sensitivity (if available)

Treatment

Health centre level:

Immediate presumptive treatment and refer to hospital Child:

Benzyl Pen 50,000 IU/kg IV or IM stat + Gentamycin 7.5mg/kg slow IV / IM stat Adult:

Chloramphenicol 1g IV or IM stat + Gentamycin 240mg slow IV or IM stat Secondary management Hospital level:

Neonate:

Benzyl Pen 50,000 IU/kg IV 8-hourly + Gentamycin 7.5 mg/kg IV 24-hourly Child:

Gentamicin 7.5.mg/kg 24-hourly + Benzyl Pen 50,000 IU/kg IV 8-hourly or Ceftriaxone 50-100 mg/kg IV 24-hourly or Chloramphenicol (if pneumococcal sepsis is suspected)

25 mg/kg IV 8-hourly (max. 1g per dose)

When stable continue to complete 10 days:

Amoxicillin 40 mg/kg/day, divided into 3 doses (8-hourly)

+ Ciprofloxacin 15 mg/kg 12-hourly Adult:

Ceftriaxone 2g IV 24-hourly When stable continue to complete 10 days:

Ciprofloxacin tablets 750 mg 12-hourly + Amoxicillin tablets 1g 8-hourly