Management of Sepsis in Hospitalized Patients

Sepsis is the leading cause of death worldwide. Mortality has improved in the past few decades but remains high, and survivors frequently have long-term complications. Initial diagnostic evaluation focuses on risk stratification and source and pathogen identification. Treatment includes intravenous fluids, vasopressors, steroids if shock is present, antimicrobial therapy targeting the most likely source of infection, and source control. Patients with shock or high-risk organ failure syndromes should be admitted early to an intensive care unit. After initial antimicrobials and resuscitation, care should focus on antimicrobial deescalation, volume management, and high-quality supportive care. Shared decision making about goals of care and transitions is important to support survivors after discharge.