Symptoms of sepsis include high fever, high heart rate, and fast breathing rate. As the infection progresses, some people experience difficulty breathing, stomach pain, confusion, and dizziness. Sepsis can also lead to dangerously low blood pressure and organ failure (septic shock). (1) Due to the gravity of this illness, sepsis isn’t something you treat at home. It requires an emergency room visit followed by admission to the hospital with close monitoring and time-sensitive treatment. Symptoms of sepsis develop after an infection such as a urinary tract infection, a skin infection, or pneumonia. It can also occur after surgery or after hospitalization for another illness. If you experience any of the symptoms of sepsis, go to the hospital or call 911. (1) There isn’t a single treatment for sepsis. Treatment varies and depends on the cause of the infection that led to sepsis, as well as the severity of symptoms. (2) Because mild sepsis can rapidly progress to severe sepsis and then septic shock, doctors must work quickly to reduce inflammation. Common treatments for sepsis include:
1. Antibiotics
Although various organisms can cause an infection that turns into sepsis, such as bacteria, viruses, or fungi, the main treatment for sepsis is antibiotics due to the fact that most cases are caused by a bacterial infection. (3) You’ll receive antibiotics immediately after your doctor diagnoses sepsis, even when test results haven’t yet confirmed a bacterial infection. Ideally, you should receive antibiotics within an hour of diagnosis. (2) Different antibiotics work better with certain types of bacteria. But because it takes time to identify the bacterium that causes an infection, you’ll receive a broad-spectrum antibiotic that can kill multiple different types of bacteria and then switch to a more targeted antibiotic later. (3) “Antibiotic treatment for sepsis varies broadly with what is infected, how at risk you are for certain types of bacteria, resistance patterns, and even availability,” says Kimberly Brown, MD, MPH, an ER doctor in Memphis, Tennessee. “We know what bacteria typically cause certain infections, so we start with broad-spectrum antibiotics to cover all possible culprits,” she says. Examples include ceftriaxone (Rocephin), piperacillin-tazobactam, cefepime (Maxipime), ceftazidime (Fortaz), vancomycin (Firvanq), ciprofloxacin (Cipro), and levofloxacin (Levaquin). If you have mild sepsis, you may receive a prescription for antibiotics to take at home. But if your condition progresses to severe sepsis, you will receive antibiotics intravenously in the hospital. This method helps the medicine get into your bloodstream quicker so it can fight the infection sooner. Once treatment begins, it can take a few hours to days for you to respond to treatment, explains Dr. Brown. After a few days of intravenous antibiotics, your doctor may switch you to a tablet antibiotic, which you’ll continue to take for several days to weeks, depending on the type of infection you have. (3) Sometimes, sepsis is caused by a viral infection. If a test confirms this, your doctor may stop the antibiotic and switch you to an antiviral. (4) However, some viruses don’t have specific antiviral treatments; in these cases, you’ll receive supportive care. On the other hand, when a fungal infection causes sepsis, you‘ll receive an intravenous antifungal drug. (5) Fungal infections that can turn into sepsis include a fungal bloodstream infection associated with catheters, a fungal infection in the gastrointestinal tract, a fungal infection in the lungs, and a fungal infection in the brain.
3. Intravenous (IV) Fluids
Even though sepsis is caused by an infection, medications alone may not be enough to maintain a healthy blood pressure. (6) Low blood pressure can occur with severe sepsis and septic shock. This is a blood pressure reading lower than 90/60 millimeters of mercury (mmHg). To increase your numbers, you’ll need to receive intravenous fluids while in the hospital. (6) Fluids help increase blood volume and prevent dehydration, which are both contributing factors of low blood pressure. Symptoms of too low pressure include shallow breathing, rapid pulse, clammy skin, and confusion. Treating low blood pressure is crucial because in this state it becomes harder for blood to carry oxygen to different parts of the body. Organ damage can occur when your body doesn’t get enough oxygen. Various types of intravenous fluids can treat sepsis and increase blood volume. These include normal saline, which has minerals such as sodium, or you may receive colloids. (6)
4. Oxygen Therapy
Because the body demands more oxygen in this state, some patients with sepsis and septic shock are placed on mechanical ventilators to give their lungs and body some rest and the ability to heal, warns Brown. This therapy helps raise the amount of oxygen the lungs receive and the amount of oxygen that’s delivered to your blood. There are different ways to receive oxygen therapy, such as through a nasal tube, a face mask, or mechanical ventilation (inserting a tube into the trachea).
5. Surgery
Once a doctor determines the source of an infection, surgery may be necessary to remove it. Situations that may require surgery include the discovery of an abscess somewhere in the body. This is a pocket of pus usually caused by a bacterial infection. (8) An abscess can form on the skin or inside of the body as a complication of another infection. Some abscesses respond to antibiotics. But sometimes, doctors must make an incision and drain an abscess or surgically remove an abscess to stop an infection. Surgery is also needed in other situations. Some people with diverticulitis, gastritis, or another inflammatory gastrointestinal (GI) condition develop a hole in their stomach, large intestine, or small intestines (gastrointestinal perforation). As a result, content from the GI tract travels to normally sterile areas in the body, such as the peritoneum, and causes an infection. Surgery is necessary to repair this hole. (9) For example, someone with a low number of red blood cells may receive a blood transfusion while in the hospital. Anemia can occur in people with sepsis, but a red blood cell transfusion can help improve oxygen delivery throughout the body. In fact, “red blood cell transfusions are recommended as part of early goal-directed therapy for patients with severe sepsis,” according to one study. (10) As sepsis progresses, kidney damage can also occur. If your kidneys stop functioning properly, you’ll need dialysis, or renal replacement therapy, to help your kidneys filter blood and remove toxins from your body. Sepsis can damage not only your kidneys but also other organs such as your heart and lungs. Therefore, your doctor may use hemodynamic monitoring to keep a close eye on your heart and lung function. (11) This machine works by measuring the blood pressure in your veins, heart, and arteries, as well as the amount of oxygen in your blood. Some people with severe sepsis and septic shock also experience hyperglycemia. This risk applies to people with diabetes and those without diabetes. It is believed that a combination of stress and inflammation can induce insulin resistance and higher glucose levels. (12) If so, you’ll receive insulin intravenously. Keep in mind that while intravenous fluids and broad-spectrum antibiotics are part of the initial response for most people with sepsis, some people don’t initially respond and need a low-dose steroid added to their treatment plan to keep their blood pressure up, says Keith Roach, MD, an internist at NewYork-Presbyterian/Weill Cornell Medical Center in New York City. Options might include dexamethasone (Decadron), hydrocortisone (Solu-CORTEF), or prednisone (Deltasone). This steroid medication helps reduce inflammation. It doesn’t work for everyone, but it has helped some people recover from sepsis. (6) Doctors may also use another type of therapy when IV fluids are unable to increase blood pressure. Some people receive vasopressor medication to constrict their blood vessels and forcefully increase their blood pressure.
Why Early Treatment Is Key for a Good Sepsis Prognosis
Between treating the source of an infection, fluids, and other types of supportive therapy, it is possible to recover from sepsis. However, the prognosis depends on how early you seek treatment. The outlook with mild sepsis is generally positive. But unfortunately, severe sepsis has a mortality rate of nearly 30 percent, (4) and some people have post-sepsis symptoms (fatigue, insomnia, cognitive decline) for weeks or months. Early detection and treatment are keys for increasing the chances of survival.
