Clinical Study
Implementing a Collaborative Sepsis Protocol on the Time to Antibiotics in an Emergency Department of a Saudi Hospital: Quasi Randomized Study
Table 1
Empiric antibiotic therapy for cases of severe sepsis or septic shock.
| Suspected source of infection | Antibiotic guidelines |
| Lung | | Community acquired | Moxifloxacin + cefotaxime or ceftriaxone or ceftazidime | Hospital acquired | Imipenem or meropenem or cefepime | Abdomen | | Community acquired | Imipenem or meropenem or piperacillin/tazobactam ± aminoglycoside | Hospital acquired | Imipenem or meropenem or piperacillin/tazobactam ± aminoglycoside (consider amphotericin B) | Skin and soft tissue | | Community acquired | Vancomycin + imipenem or meropenem or piperacillin/tazobactam | Hospital acquired | Vancomycin plus Cefepime or piperacillin/tazobactam | Urinary tract | | Community acquired | Ciprofloxacin or ampicillin and gentamycin | Hospital acquired | Vancomycin and cefepime or carbapenem | Meningitis | | Community acquired | Vancomycin + ceftriaxone or cefepime | Hospital acquired | Vancomycin + cefepime or ceftazidime | Neutropenic | | Community acquired | Carbapenem or cefepime or ceftazidime or piperacillin/tazobactam + aminoglycoside + Vancomycin (if having CVC catheter) | Hospital acquired | Same as above | Undetermined | | Community acquired | Vancomycin + imipenem or meropenem or cefepime | Hospital acquired | Same as above |
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Recommended starting antibiotic dosage for treating sepsis (normal renal function): imipenem: 0.5 gm IV; meropenem: 1.0 gm IV; piperacillin/tazobactam: 3.375 gm IV; cefepime: 1.2 gm IV; ciprofloxacin: 400 mg IV; moxifloxacin: 400 mg IV; vancomycin: 1 g IV; ceftriaxone: 2 gm IV; cefotaxime: 2 gm IV; ceftazidime: 2 g IV.
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