Risk of treatment delay in patients suspected of sepsis with moderate to high risk criteria

In the recently published NICE sepsis guidance the authors outline pathways of management stratified according to risk of severe illness and death.1 2 They recommend that patients with one moderate to high risk criterion without a definitive condition do not automatically receive early antibiotic administration within an hour but do undergo senior clinician review within three hours for consideration of antibiotics.

One such moderate to high risk criterion is behaving differently from usual. A child with fever and altered behaviour, however, could have encephalitis. The consensus guidelines of the Association …