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What Is the Treatment for Gram-Negative Sepsis?

By Clara Kedrek
Updated May 17, 2024
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The treatment for gram-negative sepsis involves providing a number of therapeutic interventions. One of the most important treatments is to give antibiotic medications. Patients who have decreased blood pressures should be treated with fluid administration and medications known as pressors. If patients are not able to breathe independently, they can be assisted with the help of a mechanical ventilator. A number of prophylactic measures to prevent the development of deep vein thrombosis, stress ulcers, ventilator-acquired pneumonia, and hyperglycemia should be undertaken.

Prompt and appropriate antibiotic therapy is perhaps the most important intervention that can be taken in patients with gram-negative sepsis. Since this condition is caused by bacterial species in the gram-negative category of bacteria, antibiotics known to be effective against these organisms should be given. Ideally, antibiotics should be started within an hour after recognizing the signs and symptoms of sepsis. If a pathogenic bacterial species is identified from one of the patients’ bodily fluids, antibiotic therapy can be tailored based on the specific susceptibility patterns of that organism. Additionally, if the cause of the sepsis is known to be an abscess or a line inserted into the patient’s vasculature, the abscess should be drained and the line removed in order to remove these sources of infection.

Often, patients with gram-negative sepsis have difficulties in maintaining the pressure within their circulatory systems, a condition known as shock. They develop low blood pressure, resulting in a lack of blood flow to different organs in the body. The first step in treating shock is giving a large amount of intravenous fluids. If this intervention is insufficient, patients might require the administration of medications known as pressors in order to maintain sufficient blood pressures. Maintaining sufficiently high intravascular pressures is important in order to prevent the development of organ dysfunction secondary to poor blood flow.

Many patients with gram-negative sepsis might require help breathing, and this is often given in the form of mechanical ventilation. Reasons for needing ventilatory support include altered mental status and metabolic derangements. Patents with sepsis should receive low-volume breaths in order to protect the tissue of the lung. Health care providers should attempt to discontinue the use of the ventilator as soon as clinically feasible.

A number of preventative measures should be undertaken in patients with gram-negative sepsis. In order to prevent the development of deep vein thrombosis (DVT), medications such as heparin are given. To prevent stress ulcers form forming in the gastrointestinal tract, anti-acid medications such as proton pump inhibitors are commonly given. Often patients with this condition might develop elevated blood glucose levels, which can be treated with insulin administration in order to prevent some of the possible side effects of hyperglycemia. In patients on a ventilator, applying antibiotic mouthwash and elevating the head of the bed to 45 degrees can decrease the risk for developing ventilator-associated pneumonia.

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