In suspected intra-abdominal sepsis, what is the cornerstone of initial management?

• A. Steroids
• B. Anticoagulation
• C. Early broad-spectrum antibiotics and source control
• D. Observation only

Answer: (C)

In suspected intra-abdominal sepsis, the key step is to rapidly start broad-spectrum antibiotics and achieve source control. This pairing tackles the systemic infection while immediately addressing the underlying nidus of infection, such as a perforated viscus, abscess, or necrotic tissue. Early antibiotic therapy helps cover the likely Gram-negative and anaerobic organisms common in abdominal infections, and prompt source control—drainage of an abscess, surgical repair, or resection as needed—removes the source of ongoing contamination and improves tissue perfusion, allowing antibiotics to work more effectively. Time matters: delays in either antibiotics or source control worsen outcomes. Steroids or anticoagulation are not the central actions for initial management, and observation alone would not control the infection.