Empiric antibiotics are not indicated for all patients with SIRS. Indications for antibiotic therapy include the following:
Suspected or diagnosed infectious etiology (eg, urinary tract infection, pneumonia, cellulitis)
Neutropenia or other immunocompromised states
Asplenia due to the potential for overwhelming postsplenectomy infection
Empiric antifungal therapy (fluconazole or an echinocandin) can be considered in patients who have already been treated with antibiotics, patients who are neutropenic, patients who are receiving total parenteral nutrition, or patients who have central venous access in place. Antiviral therapy has no role in SIRS unless the patient is immunocompromised or presents for evaluation during influenza season and the clinical picture is consistent with influenza infection.
When feasible, culture specimens should always be obtained prior to initiating antibiotic therapy. Antibiotics administered prior to culturing may be a cause of sterile sepsis.
For more on the treatment of SIRS, read here.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Michael R. Pinksy. Fast Five Quiz: How Much Do You Know About Systemic Inflammatory Response Syndrome? - Medscape - Feb 12, 2018.