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AACN Advanced Critical Care:
doi: 10.1097/NCI.0b013e31826ddccd
Symposium Pharmacotherapy for Pediatric Acute and Critical Care

Pharmacological Management of Pediatric Patients With Sepsis

Simmons, Marroyln L. PharmD, MS, BCPS; Durham, Spencer H. PharmD, BCPS; Carter, Chenita W. PharmD

Continued Education
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Abstract

With an overall mortality rate of 4.2%, sepsis is one of the most common causes of death in children worldwide. The Surviving Sepsis Campaign outlines rapid initiation of volume resuscitation with crystalloids and timely administration of broad-spectrum antibiotics as the backbone of sepsis treatment. Initial antibiotics should be broad enough to cover the most likely pathogens, but antibiotic therapy should be de-escalated when culture results become available. Therapy with a vasopressor and/or an inotrope is often necessary in patients with sepsis to improve blood pressure and cardiac output. Adjunctive therapy with hydrocortisone is sometimes beneficial in the setting of catecholamine resistance and/or adrenal insufficiency. Insulin may also be needed in some patients for the treatment of hyperglycemia. Current guidelines have improved the treatment of sepsis, but more research is needed. This article reviews sepsis pathophysiology, treatment, and supportive care specifically as they relate to pediatric patients.

© 2012 American Association of Critical–Care Nurses

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