Age - specific Antimicrobial and Antiviral Therapies for Infants and Children With Suspected Septic Shock

management strategies for infants and young children with septic shock. Septic shock is diagnosed in the clinical context of suspected infection and persistent signs of decreased perfusion. While antimicrobial therapy is directed against the common age-associated pathogens, “goal-directed” hemodynamic support is the critical focus of resuscitation of the child with septic shock. Aggressive fluid therapy and the use of inotropic drugs to attain and maintain normal cardiac index constitute the current recommendations of goal-directed therapy. Administration of up to and more than 60 ml/kg of crystalloid may be necessary during the first 30 to 60 minutes of resuscitation. In the absence of randomized controlled trials in infants and children with septic shock, dopamine is the consensus firstline drug for fluid refractory shock. Hydrocortisone therapy is reserved for use in children with catecholamine resistance and suspected or proven adrenal insufficiency. Clin Ped Emerg Med 5:20-27. © 2004 Elsevier Inc. All rights reserved. Management of Septic Shock in the Pediatric Emergency Department in 2004