Updated sepsis guidance ensures more targeted use of antibiotics
Posted 02 February 2024 - 13:02
New advice gives healthcare staff more time to examine those less severely ill before deciding whether to administer antibiotics
National guidance on the treatment of sepsis has been updated to ensure a more targeted use of antibiotics for people at a higher risk.
National Institute for Health and Care Excellence (NICE) guidelines recommend using the National Early Warning Score (NEWS2) to help assess patients with suspected sepsis and review when antibiotics should be given.
Guidance aims to help reduce risk of antibiotic resistance
NICE’s updated guidance says people identified by NEWS2 as being the most severely ill should be prioritised and continue to receive broad-spectrum antibiotics within an hour.
It also states that because of updated NEWS2 warning scores, it is expected more people will be graded by the tool as being at a lower risk level, where treatment should start within one to three hours and the diagnosis clarified before antibiotics are given. The antibiotics should be targeted at a specific infection if possible.
NICE says this will help reduce the risk of antibiotic resistance and give healthcare professionals more time to examine those who are less severely ill so they receive the right treatment.
The updated guidance applies to people who are aged 16 or over, are not and have not recently been pregnant, and are in an acute hospital setting, acute mental health setting or ambulance.
Guidance targets anitbiotics ‘to those at greatest risk of severe sepsis’
The update also includes recommendations on identifying the source of infection, which have been broadened to cover the risk of sepsis in all parts of the body and a wider range of interventions. Surgical teams should also be involved in the identification of infection where necessary.
Sepsis is a potentially life-threatening condition that occurs when the body has an abnormal immune response to an infection, which causes organs to start failing. It can be triggered by any infection, but most commonly occurs in response to bacterial infections of the lungs, urinary tract, abdominal organs or skin and soft tissues.
NICE chief medical officer Jonathan Benger said: ‘This guidance will help ensure antibiotics are targeted to those at the greatest risk of severe sepsis, so they get rapid and effective treatment. It also supports clinicians to make informed, balanced decisions when prescribing antibiotics.’
Importance of clinical judgement
An estimated five people die from sepsis every hour in the UK, according to the UK Sepsis Trust.
The charity’s founder and joint chief executive Ron Daniels said: ‘We welcome that NICE has provided this important update to its national guidance. We particularly support that the update continues to recommend the identification of high-risk factors, while reinforcing the importance of clinical judgement to prevent injudicious use of antibiotics.’
Read the NICE guidance on sepsis
Suspected sepsis: recognition, diagnosis and early management
More information on NEWS2
NHS England: National Early Warning Score
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