What are the recommended antibiotic choices for empirical treatment of sepsis in adults in primary care?

For empirical treatment of sepsis in adults in primary care, specific antibiotic choices are not universally prescribed and depend on several factors ¹,².

Generally, an intravenous broad-spectrum antibiotic should be given at the maximum recommended dose ¹. The specific choice of antibiotic will depend on the person's age, clinical presentation, the most likely source of infection, recent antibiotic use, and local antibiotic prescribing guidelines ¹.

In primary care settings, particularly in remote and rural locations where transfer time to an emergency department is routinely more than one hour, General Practitioners (GPs) should have mechanisms in place to administer antibiotics to people aged 16 or over with suspected sepsis who meet high-risk criteria, especially if they are pregnant or have recently been pregnant ¹,².

For people aged 18 years and over who require an empirical intravenous antimicrobial for suspected sepsis but have no confirmed diagnosis, an intravenous antimicrobial from the agreed local formulary should be used, in line with local (where available) or national guidelines ².

It is important to note that suspected neutropenic sepsis requires immediate hospital assessment in secondary or tertiary care ¹.