If your sepsis is detected early enough and has not affected organ or tissue function (uncomplicated sepsis), it may be possible to treat the condition at home. You will be prescribed a course of antibiotic tablets.
If the sepsis is severe or you develop septic shock, you will need emergency hospital treatment, usually in an intensive care unit (ICU). ICUs are able to support any affected body function, such as breathing or blood circulation, while the medical staff focus on treating the infection.
Treatment of severe sepsis will vary for each patient depending on the initial infection, the organs affected and the extent of damage.
Severe sepsis is treated with intravenous antibiotics (given directly into a vein). There will usually not be time to wait until a specific type of infection has been identified, so 'broad-spectrum' antibiotics will initially be given. Broad-spectrum antibiotics are designed to work against a wide range of known infectious bacteria, and can also treat some fungal infections.
Once a specific bacterium has been identified, a more 'focused' antibiotic can be used. This has the advantage of reducing the chance of the bacteria becoming resistant to antibiotics.
Intravenous antibiotics usually have to be given for 7 to 10 days.
If the sepsis is caused by a virus, antibiotics will not work. However, it is likely that antibiotics will be started anyway. This is because it would be too dangerous to delay antibiotic treatment until an accurate diagnosis is made. You will then need to wait until your body develops resistance to the effects of the virus. In some cases, antiviral medication may be given.
Source control means treating the source of the infection, such as an abscess or infected wound. This may require draining pus from infected tissue. In more serious cases, surgery may be required to remove the infected tissue and repair any damage.
Vasopressors are medicines used to treat low blood pressure. The two types of vasopressors used in the treatment of sepsis are dopamine and noradrenaline.
They can help to increase blood pressure by stimulating the muscles involved in pumping blood around the body and constricting (narrowing) the blood vessels.
Vasopressors are normally given intravenously. Extra fluids may also be given intravenously to help increase blood pressure.
Recombinant human activated protein C (rhAPC)
Recombinant human activated protein C (rhAPC) is a new type of medicine being used to treat some cases of severe sepsis. The type of rhAPC used in the UK is known as drotrecogin alfa. It contains a genetically modified type of protein molecule called protein C, which is known to reduce levels of inflammation (tissue swelling) and help prevent blood clots, both important goals in the treatment of sepsis.
RhAPC will only be used if your condition is very severe and you are at risk of dying. Drotrecogin alfa is known to cause internal bleeding in some people, so it may not be suitable if you have had a previous history of stroke or internal injury, or if you have recently had surgery.
Depending on your condition and the effect sepsis has had on your body, you may also require:
- medication, such as steroids or insulin
- a blood transfusion
- mechanical ventilation to help you breathe
- dialysis (a machine to filter your blood) to help with kidney function