SEPTICAEMIA
Clinical conditions Pathogen(s) Antibiotic(s) Comments
Note: refer to Antibiotic Man if source is suspected. Refer to Haematology or Oncology Sepsis Protocol for haematology/oncology patients.
Septicaemia in non-neutropenic             
patient		 E.coli
Strep. pneumoniae
Staph. aureus
Others		 IV Amoxicillin + Metronidazole + Gentamicin If penicillin allergic IV Vancomycin + Metronidazole + Gentamicin
Septicaemia in neutropenic
patient

Coliforms
Pseudomonas
Staphylococci
Viridans streptococci

 IV piperacillin/
tazobactam + IV gentamicin 		Seek specialist advice.  Teicoplanin IV should be added when suspect line sepsis or failure of resolution of fever 48 hours after commencement of antibiotics.
Septicaemia in patients with intravascular catheter in situ

Staph. epidermidis
Staph. aureus

 High dose flucloxacillin Consider removing the catheter.  Consider also changing to IV vancomycin if no improvement or if MRSA/MRSE is isolated in blood culture or patient is known to be MRSA positive.

*Reference: BSAC Guidelines, Journal of Antimicrobial Chemotherapy (Nov) 2004; 54: 971-81

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