Treatment is based on the following principles:
•
Infection control
• Antimicrobials
• Plasma therapy
• Identification of any infected focus and local treatment if possible
• Repeatedly check for infected foci
Ø Big six – lungs, GIT, urinary tract, joints/physes, umbilical remnant,
catheter
• Supportive care
Antimicrobial therapy
Antimicrobial therapy should be started as soon as possible. In human
patients current guidelines recommend antimicrobial treatment within 1 hour
of recognition of severe sepsis or septic shock. [6] Each hour of delay in
administering effective antibiotics is associated with a marked increase in
mortality in human studies. Establishing vascular access and initiating fluid
therapy are often prioritised in management of these patients; initiation of
antimicrobial treatment should also be prioritised.
Antimicrobial choice should take into consideration known susceptibility
patterns in the area, hydration status of the foal and concerns over
development of antimicrobial resistance, particularly in relation to
antimicrobials that are important in human health e.g. cephalosporins. It’s
important to recognise that susceptibility patterns change over time in
response to antimicrobial use in the area. [7] Required antimicrobial dose and
dosing interval are dependent on the MIC of organism involved and patient
factors but an approximate guideline is presented in the table below based on
MIC values for organisms co