Fast Five Quiz: How Much Do You Know About Systemic Inflammatory Response Syndrome?

Michael R. Pinksy, MD, CM, Dr(HC), FCCP, MCCM


February 12, 2018

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)

  • Hemodynamic instability

  • 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.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.