Sepsis (peds) - Revision history

Ostermayer at 17:15, 17 January 2026

2026-01-17T17:15:51Z

← Older revision		Revision as of 17:15, 17 January 2026
Line 1:		Line 1:
	{{~~Peds top~~}} ~~[[Sepsis]].''~~		{{PediatricPage\|Sepsis}}
	==Background==		==Background==
	*Defined as a dysregulated host response to infection that leads to life-threatening organ dysfunction<ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>		*Defined as a dysregulated host response to infection that leads to life-threatening organ dysfunction<ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>

Rossdonaldson1: /* Neonatal */

2026-01-14T22:59:08Z

Neonatal

← Older revision		Revision as of 22:59, 14 January 2026
Line 82:		Line 82:
	*Well appearing		*Well appearing
	**[[Ampicillin]] 50mg/kg Q8h + [[gentamicin]] 2.5mg/kg q24, AND<ref>Harbor-UCLA ID Guidelines 2026</ref>		**[[Ampicillin]] 50mg/kg Q8h + [[gentamicin]] 2.5mg/kg q24, AND<ref>Harbor-UCLA ID Guidelines 2026</ref>
	**Consider [[Acyclovir]] 20 mg/kg/DOSE IV Q8<ref>Harbor-UCLA ID Guidelines 2026</ref>		**Consider [[Acyclovir]] 20 mg/kg/DOSE IV Q8, if any one of the following:<ref>Harbor-UCLA ID Guidelines 2026</ref>
	***Indications (any one of the following):		***Perinatal [[HSV]] contact
	****Perinatal [[HSV]] contact		***[[Seizures]]
	****Seizures		***Abnormal [[neuro exam]]
	****Abnormal neuro exam		***[[Vesicles]]
	****Vesicles		***[[Thrombocytopenia]]
	****Thrombocytopenia		***Elevated transaminases
	****Elevated transaminases		***[[CSF]] pleocytosis with (-) gram stain
	****CSF pleocytosis with (-) gram stain

	====Peds====		====Peds====

Rossdonaldson1: /* Neonatal */

2026-01-14T22:58:18Z

Neonatal

← Older revision		Revision as of 22:58, 14 January 2026
Line 79:		Line 79:
	====Neonatal====		====Neonatal====
	*Ill-appearing and/or concern for [[meningitis]]		*Ill-appearing and/or concern for [[meningitis]]
	**[[Ampicillin]] 50mg/kg ~~q8h~~ + ([[Ceftazidime]] or [[cefotaxime]])~~, AND~~		**[[Ampicillin]] 50mg/kg Q8h + ([[Ceftazidime]] or [[cefotaxime]]) + [[Acyclovir]] 20 mg/kg/DOSE IV Q8<ref>Harbor-UCLA ID Guidelines 2026</ref>
	**Consider [[Acyclovir]] 20 mg/kg/DOSE IV Q8
	*Well appearing		*Well appearing
	**[[Ampicillin]] 50mg/kg ~~q8h~~ + [[gentamicin]] 2.5mg/kg q24, AND		**[[Ampicillin]] 50mg/kg Q8h + [[gentamicin]] 2.5mg/kg q24, AND<ref>Harbor-UCLA ID Guidelines 2026</ref>
	**Consider [[Acyclovir]] 20 mg/kg/DOSE IV Q8		**Consider [[Acyclovir]] 20 mg/kg/DOSE IV Q8<ref>Harbor-UCLA ID Guidelines 2026</ref>
			***Indications (any one of the following):
			****Perinatal [[HSV]] contact
			****Seizures
			****Abnormal neuro exam
			****Vesicles
			****Thrombocytopenia
			****Elevated transaminases
			****CSF pleocytosis with (-) gram stain

	====Peds====		====Peds====

Rossdonaldson1: /* Neonatal */

2026-01-14T22:55:23Z

Neonatal

← Older revision		Revision as of 22:55, 14 January 2026
Line 78:		Line 78:

	====Neonatal====		====Neonatal====
	*[[Ampicillin]] 50mg/kg q8h + [[~~gentamicin~~]] ~~2.5mg/kg q24h +~~ [[~~acyclovir~~]]		*Ill-appearing and/or concern for [[meningitis]]
	**~~If gram-negative strongly suspected replace~~ [[~~gentamicin~~]] ~~with~~ [[~~cefotaxime~~]] or [[~~ceftazadine~~]]		**[[Ampicillin]] 50mg/kg q8h + ([[Ceftazidime]] or [[cefotaxime]]), AND
	***Have better CNS penetration		**Consider [[Acyclovir]] 20 mg/kg/DOSE IV Q8
			*Well appearing
			**[[Ampicillin]] 50mg/kg q8h + [[gentamicin]] 2.5mg/kg q24, AND
			**Consider [[Acyclovir]] 20 mg/kg/DOSE IV Q8

	====Peds====		====Peds====

Ostermayer: /* Empiric Broad-Spectrum Antibiotics */

2025-07-05T22:42:59Z

Empiric Broad-Spectrum Antibiotics

← Older revision		Revision as of 22:42, 5 July 2025
Line 81:		Line 81:
	**If gram-negative strongly suspected replace [[gentamicin]] with [[cefotaxime]] or [[ceftazadine]]		**If gram-negative strongly suspected replace [[gentamicin]] with [[cefotaxime]] or [[ceftazadine]]
	***Have better CNS penetration		***Have better CNS penetration

	~~{{Infant fever well antibiotics}}~~

	====Peds====		====Peds====
Line 91:		Line 89:
	'''OR'''		'''OR'''
	*[[Carbapenem]] ± [[aminoglycoside]] ± [[vancomycin]]		*[[Carbapenem]] ± [[aminoglycoside]] ± [[vancomycin]]

			{{Infant fever well antibiotics}}

	===Fluid Resuscitation===		===Fluid Resuscitation===

Ostermayer: /* Neonatal */

2025-07-05T22:42:19Z

Neonatal

← Older revision		Revision as of 22:42, 5 July 2025
Line 81:		Line 81:
	**If gram-negative strongly suspected replace [[gentamicin]] with [[cefotaxime]] or [[ceftazadine]]		**If gram-negative strongly suspected replace [[gentamicin]] with [[cefotaxime]] or [[ceftazadine]]
	***Have better CNS penetration		***Have better CNS penetration

			{{Infant fever well antibiotics}}

	====Peds====		====Peds====

Tomfadial: Modify age group reference

2024-12-22T04:26:57Z

Modify age group reference

← Older revision		Revision as of 04:26, 22 December 2024
Line 1:		Line 1:
	{{~~Adult~~ top}} [[Sepsis]].''		{{Peds top}} [[Sepsis]].''
	==Background==		==Background==
	*Defined as a dysregulated host response to infection that leads to life-threatening organ dysfunction<ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>		*Defined as a dysregulated host response to infection that leads to life-threatening organ dysfunction<ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>

Rossdonaldson1: /* Vasopressors */

2024-06-12T20:46:37Z

Vasopressors

← Older revision		Revision as of 20:46, 12 June 2024
Line 101:		Line 101:
	**Continue to have abnormal perfusion after 40-60 mL/kg of fluid resuscitation		**Continue to have abnormal perfusion after 40-60 mL/kg of fluid resuscitation
	*1st line: [[epinephrine]] or [[norepinephrine]] (i.e., ''not'' dopamine)<ref>Marik PE. Dopamine increases mortality in pediatric septic shock. Journal of Pediatrics. January 2016, Volume 168, Pages 253–256.</ref><ref>Ventura AM, Shieh HH, Bousso A, Goes PF, Fernandes IC, de Souza DC, et al. Double-Blind Prospective Randomized Controlled Trial of Dopamine Versus [[Epinephrine]]as First-Line Vasoactive Drugs in Pediatric Septic Shock. Crit Care Med 2015;43:2292-302. </ref><ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>		*1st line: [[epinephrine]] or [[norepinephrine]] (i.e., ''not'' dopamine)<ref>Marik PE. Dopamine increases mortality in pediatric septic shock. Journal of Pediatrics. January 2016, Volume 168, Pages 253–256.</ref><ref>Ventura AM, Shieh HH, Bousso A, Goes PF, Fernandes IC, de Souza DC, et al. Double-Blind Prospective Randomized Controlled Trial of Dopamine Versus [[Epinephrine]]as First-Line Vasoactive Drugs in Pediatric Septic Shock. Crit Care Med 2015;43:2292-302. </ref><ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>
	*2nd and 3rd line: consider [[epinephrine]], [[norepinephrine]], [[dobutamine]], milrinone, [[vasopressin]], angiotensin II<ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>		*2nd and 3rd line: consider [[epinephrine]], [[norepinephrine]], [[dobutamine]], [[milrinone]], [[vasopressin]], angiotensin II<ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>

	===Corticosteroids===		===Corticosteroids===

Rossdonaldson1: /* Vasopressors */

2024-06-12T20:45:55Z

Vasopressors

← Older revision		Revision as of 20:45, 12 June 2024
Line 99:		Line 99:
	**Myocardial dysfunction		**Myocardial dysfunction
	**Shock in the setting of fluid overload		**Shock in the setting of fluid overload
	**Continue to have abnormal perfusion after 40 to 60 mL/kg of fluid resuscitation		**Continue to have abnormal perfusion after 40-60 mL/kg of fluid resuscitation
	*1st line: [[epinephrine]] or [[norepinephrine]] (i.e., ''not'' dopamine)<ref>Marik PE. Dopamine increases mortality in pediatric septic shock. Journal of Pediatrics. January 2016, Volume 168, Pages 253–256.</ref><ref>Ventura AM, Shieh HH, Bousso A, Goes PF, Fernandes IC, de Souza DC, et al. Double-Blind Prospective Randomized Controlled Trial of Dopamine Versus [[Epinephrine]]as First-Line Vasoactive Drugs in Pediatric Septic Shock. Crit Care Med 2015;43:2292-302. </ref><ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>		*1st line: [[epinephrine]] or [[norepinephrine]] (i.e., ''not'' dopamine)<ref>Marik PE. Dopamine increases mortality in pediatric septic shock. Journal of Pediatrics. January 2016, Volume 168, Pages 253–256.</ref><ref>Ventura AM, Shieh HH, Bousso A, Goes PF, Fernandes IC, de Souza DC, et al. Double-Blind Prospective Randomized Controlled Trial of Dopamine Versus [[Epinephrine]]as First-Line Vasoactive Drugs in Pediatric Septic Shock. Crit Care Med 2015;43:2292-302. </ref><ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>
	*2nd and 3rd line: consider [[epinephrine]], [[norepinephrine]], [[dobutamine]], milrinone, [[vasopressin]], angiotensin II<ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>		*2nd and 3rd line: consider [[epinephrine]], [[norepinephrine]], [[dobutamine]], milrinone, [[vasopressin]], angiotensin II<ref>Weiss SL, Fitzgerald JC. Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics (2024) 153 (1): e2023062967. https://doi.org/10.1542/peds.2023-062967</ref>

Rossdonaldson1 at 20:38, 12 June 2024

2024-06-12T20:38:15Z

@@ Line 1: / Line 1: @@
 {{Adult top}} [[Sepsis]].''
 ==Background==
 *Tachycardia is typically most predominant, hypotension is a late and ominous sign
 ==Clinical Features==
@@ Line 32: / Line 23: @@
 | Pulse Pressure || Widen || Narrow
 |}
 ==Differential Diagnosis==