Sepsis is a life-threatening response to infection that contributes significantly to neonatal and pediatric morbidity and mortality worldwide. The key tenets of care include early recognition of potential sepsis, rapid intervention with appropriate fluids to restore adequate tissue perfusion, and empiric antibiotics to cover likely pathogens. Vasoactive/inotropic agents are recommended if tissue perfusion and hemodynamics are inadequate following initial fluid resuscitation. Several adjunctive therapies have been suggested with theoretical benefit, though definitive recommendations are not yet supported by research reports. This review focuses on the recommendations for medication and fluid management of pediatric sepsis and septic shock, highlighting issues related to antibiotic choices and antimicrobial stewardship, selection of intravenous fluids for resuscitation, and selection and use of vasoactive/inotropic medications. Controversy remains regarding resuscitation fluid volume and type, antibiotic choices depending upon infectious risks in the patient’s community, and adjunctive therapies such as vitamin C, corticosteroids, intravenous immunoglobulin, and methylene blue. We include best practice recommendations based on international guidelines, a review of primary literature, and a discussion of ongoing clinical trials and the nuances of therapeutic choices.

脓毒症是对感染的威胁生命的反应，对全球新生儿和儿童的发病率和死亡率有显着影响。护理的关键原则包括早期识别潜在的脓毒症，使用适当的液体快速干预以恢复足够的组织灌注，以及经验性抗生素以覆盖可能的病原体。如果初始液体复苏后组织灌注和血流动力学不足，建议使用血管活性/正性肌力药物。尽管研究报告尚未支持明确的建议，但已经提出了几种具有理论益处的辅助疗法。本综述侧重于对小儿脓毒症和感染性休克的药物和液体管理的建议，强调与抗生素选择和抗菌药物管理相关的问题，选择用于复苏的静脉输液，以及选择和使用血管活性/正性肌力药物。关于复苏液的体积和类型、取决于患者社区感染风险的抗生素选择以及维生素 C、皮质类固醇、静脉注射免疫球蛋白和亚甲蓝等辅助疗法，仍存在争议。我们包括基于国际指南的最佳实践建议、对原始文献的回顾以及对正在进行的临床试验和治疗选择细微差别的讨论。静脉注射免疫球蛋白和亚甲蓝。我们包括基于国际指南的最佳实践建议、对原始文献的回顾以及对正在进行的临床试验和治疗选择细微差别的讨论。静脉注射免疫球蛋白和亚甲蓝。我们包括基于国际指南的最佳实践建议、对原始文献的回顾以及对正在进行的临床试验和治疗选择细微差别的讨论。