Pediatric Sepsis Guidelines

Updated: Dec 14, 2022
  • Author: Shankar Santhanam, MD; Chief Editor: Russell W Steele, MD  more...
  • Print

Guidelines Summary

Japanese Association for Infectious Diseases/Japanese Society of Chemotherapy

Guidelines on the treatment of sepsis and catheter-related bloodstream infections were published in 2021 by the Japanese Association for Infectious Diseases/Japanese Society of Chemotherapy. [40] Highlights of treatment recommendations for children are as follows:

Treatment of sepsis in children

For patients with community-acquired sepsis, administer cefotaxime or ceftriaxone as empiric therapy. Add vancomycin to the regimen in areas where Staphylococcus aureus infection is common.

For children with nosocomial sepsis, select drugs on the basis of the regional prevalence of infections, the site of onset (community or hospital), underlying conditions, and risk factors (eg, medical devices, neutropenia).

Treatment of sepsis in neonates

For patients with early-onset sepsis, administer an empiric regimen that includes ampicillin and gentamicin or ampicillin and cefotaxime. For those with late-onset sepsis, the selection of empiric therapy is guided by institutional and regional antibiograms.

Treatment of catheter-related bloodstream infections

For children, empiric therapy should include vancomycin and third- or fourth-generation cephems or carbapenems. Antifungal agents are recommended for patients on total parenteral nutrition, those receiving long-term broad-spectrum antimicrobial therapy, those with hematologic malignancies, and those who underwent transplantation, as well as patients with fungal infections.