Antimicrobial Therapy in Paediatric Sepsis and Treatment Strategy

Abstract

Sepsis is a complex and severe disorder that significantly affects the pediatric population and is responsible for approximately 7.5 million deaths annually. Sepsis is a potentially fatal reaction to infection that greatly increases neonatal and pediatric morbidity and mortality globally. Sepsis can also lead to more severe forms, such as severe sepsis, septic shock, multiorgan failure, and refractory septic shock in cases with known or suspected infections. Early diagnosis, prompt administration of the proper fluids to restore adequate tissue perfusion, and empiric antimicrobial therapy to protect against suspected infections are the main tenets of therapy. If, after initial fluid resuscitation, tissue perfusion and hemodynamics are unstable/insufficient, vasoactive medications are advised. Ampicillin and gentamicin are recommended for use in early onset neonatal sepsis while third generation cephalosporins are also included in the treatment regime in case of late-onset sepsis. A broad-spectrum antibiotic that treats both gram-positive and gramnegative bacteria is advised for 1 month above children, but the choice of antibiotic depends on the clinical presentation, such as pneumonia, bloodstream infection, intra-abdominal sepsis, or meningitis that resulted in septic shock. A delay in antimicrobial administration is linked to increased mortality rate hence, guidelines recommend antimicrobial administration within 1 hour after confirmation of sepsis. There is substantial evidence to support the notion that rapid antimicrobial initiation and selection are essential components of the therapy of patients with severe illnesses. The purpose of this research is to review the available information about antimicrobial therapy in paediatric sepsis and treatment strategy