*2.1.2 Guidelines for the management of sepsis spectrum disorders*

The Surviving Sepsis Campaign (SSC) guidelines offer recommendations for the resuscitation of patients with suspected sepsis spectrum disorders [8]. However, while these guidelines can provide an overview for the care of these patients, treatment should always be primarily guided by repeated clinical assessment and reassessment of these patients. Current guidelines recommend the continuous administration of crystalloid fluids as long as hemodynamic factors continue to improve [8] If 30 ml/kg ideal body weight (IBW) balanced crystalloid fluids does not achieve a MAP ≥65 mm Hg, a vasoactive agent should be started [8]. Norepinephrine is currently the vasopressor of choice patients with septic shock [8]. The cornerstone of management of sepsis spectrum disorders is prompt source control through administration of antimicrobials or, if necessary, surgical intervention [8]. Cultures should be collected before the first dose of antimicrobial medications; culture collection should not delay source control interventions [8]. In the emergency department, early broad-spectrum antimicrobial therapy should be initiated based on the pathogen profile of the suspected site of infection, the patient's prior culture results and susceptibilities, and local pathogen prevalence and resistance patterns. The spectrum of the antimicrobial agents can be narrowed as culture results become available or the patient presentation changes. Input from clinical pharmacists in the ED can assist in optimizing the initial antimicrobial choice and has been shown to decrease time to antibiotic administration, improve antibiotic stewardship, and improve patient outcomes [9–12].
