American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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The selection of appropriate antimicrobial therapy for patients with sepsis is discussed. Antimicrobial selection is based on the most likely source of infection, the most common pathogens at that site, knowledge of antimicrobial susceptibility patterns in the local community and institution, and host factors. Prompt initiation of appropriate antimicrobial therapy is essential for achieving the best possible outcomes. ⋯ An antipseudomonal beta-lactam with or without an aminoglycoside is recommended for initial therapy in most patients. The role of monotherapy versus combination therapy is controversial. Routine use of vancomycin and antifungal therapy as part of initial regimens should be discouraged but may be justified in specific circumstances.