title: Pharmacological management of pediatric patients with sepsis.
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.
authors.affiliation: Sacred Heart Hospital/Children's Hospital at Sacred Heart, 5151 N 9th Ave, Pensacola, FL 32304, USA. mlsimmons@shhpens.org
authors.forename: Marroyln L
authors.initials: ML
authors.lastname: Simmons
authors.forename: Spencer H
authors.initials: SH
authors.lastname: Durham
authors.forename: Chenita W
authors.initials: CW
authors.lastname: Carter
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003422:Critical Care; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D010372:Pediatrics / Q000379:methods*; D012151:Resuscitation / Q000379:methods* / Q000451:nursing; D018805:Sepsis / Q000188:drug therapy* / Q000401:mortality / Q000451:nursing / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D002316:Cardiotonic Agents; D007004:Hypoglycemic Agents; D007328:Insulin; D014662:Vasoconstrictor Agents; D006854:Hydrocortisone