Patients with sepsis or septic shock

Patients with sepsis or septic shock should be administered antibiotics immediately, ideally within one hour of recognition.

Patients at HIGH RISK of MDR (Multi-Drug Resistant) infections should receive two antimicrobials with gram-negative coverage for empiric treatment.

Key principles for antibiotic administration:

• Dosing and delivery of antibiotics must be based on PK/PD (Pharmacokinetics/Pharmacodynamics) principles and specific drug properties.
• Aminoglycosides: Use extended-interval dosing.
• Beta-lactams: Prefer prolonged infusion.

Administering loading doses is essential to avoid delays in achieving effective concentrations, followed by adjustments based on renal clearance and other PK/PD parameters.

Daily assessment for de-escalation of antimicrobials is recommended instead of fixed durations of therapy without reassessment.