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Sepsis guidelines revised for treating patients who are less ill

Significant change in approach suggests allowing more time for tests on some patients, ensuring best outcomes and helping tackle antimicrobial resistance
Picture shows a nurse at the bedside of an elderly patient while another nurse looks at a sepsis checklist

Significant change in approach suggests allowing more time for tests on some patients, ensuring best outcomes and helping tackle antimicrobial resistance

Picture shows a nurse at the bedside of an elderly patient while another nurse looks at a sepsis checklist
Picture: Tim George

Nurses and other clinicians should have more time to assess and treat patients with suspected sepsis instead of rushing to administer antibiotics, says new guidance.

The guidelines, published by the Royal Academy of Medical Colleges, propose a significant change in approach when it comes to treating the potentially life-threatening condition.

Current national guidance recommends that all patients with suspected sepsis should be given IV antibiotics within an hour of diagnosis, with antibiotics stopped or changed once test results are in.

However, the new guidelines call for a more measured approach, depending on the severity of illness, to ensure the best outcomes for patients and to tackle antimicrobial resistance.

New guidance is based on research and feedback from professionals and patients

Under the guidance, which is based on the latest research and feedback from professionals and patients, the sickest patients would continue to be given antibiotics within an hour.

But clinicians would have more time to complete tests for those who are less ill and ensure they get the right antibiotics if necessary.

RCN professional lead for critical care Suman Shrestha said: ‘Previously, the focus has been on administration of antibiotics within an hour for patients with sepsis. The new evidence shows that not all patients, particularly those who are less sick, benefit from this.

‘What is important is that we give staff more time to assess, obtain senior clinician review if needed and provide accurate diagnosis and treatment.’

The guidance has also been welcomed by the UK Sepsis Trust. Chief executive Ron Daniels said: ‘Increased awareness of, and education around, the grave dangers of sepsis over the past decade have culminated in the important new guidance published today.’

The new approach to treating sepsis

  • National Early Warning Score (NEWS) score and clinical judgement used to assess patients with suspected sepsis
  • Adult patients in septic shock, those whose condition is rapidly going downhill or with a NEWS score of 7 or more should get broad spectrum antibiotics within an hour of score being recorded
  • Clinicians can take more time to assess, treat and choose the right antibiotics for those with lower NEWS scores – up to three hours for those with scores of 5 or 6, or up to six hours for those with the lowest scores
  • Patients in high-risk groups may still get rapid treatment even if NEWS score is low

Source: Academy of Medical Royal Colleges


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