Suspected sepsis: recognition, diagnosis and early management
NICE is updating its guideline on suspected sepsis: recognition, diagnosis and early management (NG51).
Updates in progress
For people covered by NEWS2 (people aged 16 and over who are not and have not recently been pregnant):
- source control
- rapid antigen tests for sepsis
- indicators of organ hypoperfusion
- intravenous fluids
- vasopressors.
For all populations: people who are most at risk of developing sepsis.
See the guideline in development page for more detail on this update.
The update will be developed using the methods and processes outlined in:
- Developing NICE guidelines: the manual
- Appendix M: Interim principles for methods and processes for supporting digital living guideline recommendations
- Appendix N: Multi-criteria decision framework for deciding whether to develop or update recommendations and which methods to use.
Areas we're monitoring
In the future, we plan to review the use of the paediatric early warning score (PEWS) and maternity early warning score (MEWS) tools, and consider making recommendations on them in the guideline.
Procalcitonin (PCT) testing was also indicated by the guideline committee as a possible area for update. However, PCT testing is covered by the NICE diagnostics guidance on procalcitonin testing for diagnosing and monitoring sepsis. The ongoing PRONTO trial is comparing PCT‑supported assessment with standard care for suspected sepsis in adults at emergency departments, to measure whether this approach reduces antibiotic prescriptions without increasing mortality. We will decide whether to update our recommendations on PCT testing once this trial completes.