Life-threatening conditions

Quality statement 1

A patient with a life-threatening condition due to a suspected infection receives an appropriate antimicrobial immediately, without waiting for the results of investigations.

Purpose

To ensure access to timely and appropriate antimicrobial treatment for consumers with suspected life-threatening infections that can lead to sepsis1, septic shock, bacterial meningitis, febrile neutropenia or necrotising fasciitis, when clinically appropriate.

For patients

Infections can be serious and may be life threatening. Examples of these conditions include: 

  • Sepsis (when the body’s response to an infection injures its own tissues and organs) 
  • Meningitis (an infection of the tissues lining the brain) 
  • Necrotising fasciitis (a serious infection from a flesh-eating bacteria).

If you are unwell with a serious infection, you will be given appropriate medicine to treat the infection without delay.

For clinicians

When treating a patient with suspected sepsis1 or another life-threatening infection, administer appropriate empiric antimicrobials as soon as possible. There should be prompt access to the appropriate antimicrobials.

Obtain clinical specimens as appropriate, but do not delay administration of antimicrobials and do not wait for results of investigations. When results are received, immediately reassess the treatment.

If there is no immediate access to the appropriate antimicrobials, arrange for immediate transfer of the patient to an acute care facility; for example, ambulance transfer to a hospital. This is relevant in community settings or for some rural hospitals. 

 

End-of-life care

When considering the administration of antimicrobials for patients with life-threatening or serious infections, the patient’s advance care plan should be considered. Safe and high-quality end-of-life care should be aligned with the values, needs and wishes of the individual, and their family or carers. For ethical reasons, it is important not to harm patients approaching the end of life by providing burdensome investigations and treatments that can be of no benefit.2

For health service organisations

Ensure that relevant clinical pathways and an appropriate local antimicrobial formulary are available so that clinicians can give optimal antimicrobial treatment promptly and within recommended time frames to patients with life-threatening infections.

For patients

Infections can be serious and may be life threatening. Examples of these conditions include: 

  • Sepsis (when the body’s response to an infection injures its own tissues and organs) 
  • Meningitis (an infection of the tissues lining the brain) 
  • Necrotising fasciitis (a serious infection from a flesh-eating bacteria).

If you are unwell with a serious infection, you will be given appropriate medicine to treat the infection without delay.

For clinicians

When treating a patient with suspected sepsis1 or another life-threatening infection, administer appropriate empiric antimicrobials as soon as possible. There should be prompt access to the appropriate antimicrobials.

Obtain clinical specimens as appropriate, but do not delay administration of antimicrobials and do not wait for results of investigations. When results are received, immediately reassess the treatment.

If there is no immediate access to the appropriate antimicrobials, arrange for immediate transfer of the patient to an acute care facility; for example, ambulance transfer to a hospital. This is relevant in community settings or for some rural hospitals. 

 

End-of-life care

When considering the administration of antimicrobials for patients with life-threatening or serious infections, the patient’s advance care plan should be considered. Safe and high-quality end-of-life care should be aligned with the values, needs and wishes of the individual, and their family or carers. For ethical reasons, it is important not to harm patients approaching the end of life by providing burdensome investigations and treatments that can be of no benefit.2

For health service organisations

Ensure that relevant clinical pathways and an appropriate local antimicrobial formulary are available so that clinicians can give optimal antimicrobial treatment promptly and within recommended time frames to patients with life-threatening infections.

Read Quality statement 2 - Use of guidelines.

Related resources

The Commission is developing a Sepsis Clinical Care Standard, which will be relevant to this quality statement.

References

1. Sepsis as defined by the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). See the glossary in the Antimicrobial Stewardship Clinical Care Standard for further information.

2. Australian Commission on Safety and Quality in Health Care. National Consensus Statement: essential elements for safe and high-quality end-of-life care. Sydney: ACSQHC; 2015.