Standard regimen for hospital-acquired sepsis or septic shock in children 2 months or older

For children 2 months or older with hospital-acquired sepsis or septic shock of unknown source, in the absence of local protocols or expert advice, useAbdul-Aziz, 2024Dulhunty, 2024:

piperacillin+tazobactam intravenously piperacillin + tazobactam

child without septic shock and not requiring intensive care support: 100+12.5 mg/kg up to 4+0.5 g, 6-hourly

child with septic shock or requiring intensive care support: 100+12.5 mg/kg up to 4+0.5 g administered as a loading dose over 30 minutes. After 3 hours, start a continuous infusion of 400+50 mg/kg up to 16+2 g administered over 24 hours12

PLUS if the child has septic shock, suspected line-related sepsis or other risk factors for MRSA infection

vancomycin intravenously; for initial dosing, see Intermittent vancomycin dosing for young infants and children.

For children 2 months or older in whom toxic shock syndrome is suspected3, add to the above regimen:

clindamycin 15 mg/kg up to 600 mg intravenously, 8-hourly for a minimum of 72 hours and until organ function has significantly improved4 clindamycin

PLUS

intravenous immunoglobulin (IVIg) 2 g/kg intravenously, as a single dose as soon as possible but not later than 72 hours. It is reasonable to give the dose in divided doses if it is not possible to give a single dose.

For children at risk of invasive Candida infection, consider the addition of an empirical antifungal.

This empirical regimen is intended for initial therapy only (up to 48 hours). Modify therapy as soon as additional information is available (eg source of infection, results of Gram stain, culture and susceptibility testing). Evaluate the appropriateness of antimicrobial therapy daily, with consideration given to the patient’s clinical status and the principles of antimicrobial stewardship.

1 For patients with septic shock or requiring intensive care support, administering the total daily dose of piperacillin+tazobactam over 24 hours is preferred to ensure adequate drug exposure. If this is not possible (eg the patient is receiving other drugs via the same line), administer the standard dose (100+12.5 mg/kg up to 4+0.5 g, 6-hourly) as an extended infusion over 3 hours. If a 3-hour infusion is not possible, administer over 30 minutes. For more information, see Practical information on using beta lactams: penicillins.Return
2 The modified dosage of piperacillin+tazobactam for patients with septic shock or those requiring intensive care support is recommended to ensure adequate drug exposure, because pharmacokinetics may be altered in patients with critical illness (eg because of enhanced kidney clearance or changes in volume of distribution). Once the critical illness has resolved, consider switching to the standard dosage.Return
3 In children, signs of toxic shock syndrome include fever, hypotension, rash and evidence of organ dysfunction. For more information, see Streptococcal toxic shock syndrome.Return
4 There are more clinical and microbiological data to support the use of clindamycin than lincomycin. Intravenous lincomycin can be used at the same dosage if clindamycin is unavailable or if a local protocol recommends its use.Return