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Updated NICE guidance recommends more targeting of antibiotics to combat sepsis 

NICE has updated its guidance for suspected sepsis, recommending better targeting of antibiotics to ensure the right people receive treatment as soon as possible but the medicines are not overused, which can lead to antibiotic resistance.

National Early Warning Score (NEWS2) is the NHS England endorsed system to identify acutely ill patients, including those with sepsis.  

National Institute for Health and Care Excellence (NICE) guidance recommends using NEWS2 to help assess people with suspected sepsis who are aged 16 or over, are not and have not recently been pregnant, and are in an acute hospital setting, acute mental health setting or ambulance.  

This recommendation is included in a partial update of NICE’s recognition, diagnosis, and early management of suspected sepsis guideline alongside further advice on assessing patients most at risk, when to give antibiotics and identifying the source of infection.  

The guideline states people graded by NEWS2 as being the most severely ill should be prioritised and continue to receive broad-spectrum antibiotics within an hour.  

As a result of the updated NEWS2 warning scores, it is expected that more people will be graded at a lower risk level where treatment should begin within 1-3 hours and the diagnosis clarified before antibiotics are given, targeted at a specific infection if possible.  

This will help to reduce the risk of antibiotic resistance and give healthcare professionals more time to investigate those who are less severely ill, so they receive the right treatment.  

There are at least 245,000 sepsis cases diagnosed in the UK every year. An analysis of data by the UK Sepsis Trust in 2017 showed that there were 200,000 admissions to hospitals in England where sepsis was diagnosed.   

Professor Jonathan Benger, NICE chief medical officer said: “This useful and useable guidance will help ensure antibiotics are targeted to those at the greatest risk of severe sepsis, so they get rapid and effective treatment. It also supports clinicians to make informed, balanced decisions when prescribing antibiotics. We know that sepsis can be difficult to diagnose so it is vital there is clear guidance on the updated NEWS2 so it can be used to identify illness, ensure people receive the right treatment in the right clinical setting and save lives.”

Read the full update to the suspected sepsis: recognition, diagnosis, and early management guidance on the NICE website.  

 

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20 March, 2024

Interpreting Reports: UK NEQAS Haematology

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