In suspected intra-abdominal sepsis, what are the two key elements of initial management?

• A. Steroids and fluid restriction
• B. Anticoagulation and analgesia
• C. Early broad-spectrum antibiotics and source control
• D. Observation and bed rest

Answer: (C)

In suspected intra-abdominal sepsis the priorities are to rapidly kill the invading organisms and eliminate the source of infection. The two crucial steps are early broad-spectrum antibiotics to cover likely pathogens (including gram-negative bacteria and anaerobes) and prompt source control to remove the nidus of infection—such as draining an abscess, debridement, or repairing/closing an perforation. Antibiotics without addressing the source won’t halt ongoing infection, and source control without antibiotics won’t clear bacteremia. Other options like steroids with fluid restriction or just observation and bed rest do not treat the infectious process and are not appropriate initial management.