What is the initial management step for a patient with suspected sepsis and hypotension?

• A. Antibiotics after cultures return
• B. IV fluids only
• C. Prompt broad-spectrum antibiotics and IV fluids within the first hour
• D. Steroids only

Answer: (C)

In suspected sepsis with hypotension, the first priority is rapid restoration of perfusion and control of the infection. Administer broad-spectrum antibiotics and begin IV fluid resuscitation within the first hour. This combination targets the underlying infection promptly and improves intravascular volume to support tissue perfusion, both of which are critical for survival. Draw blood cultures and other relevant cultures before giving antibiotics if it can be done quickly, but do not delay antibiotic therapy for culture results. Steroids or other therapies aren’t the initial step unless specific indications arise; focusing on antibiotics plus fluids addresses the immediate life-threatening physiology of septic shock.