RACGP aged care clinical guide (Silver Book) Silver Book – Part A Infection and sepsis

Infection and sepsis (ie life-threatening organ dysfunction) are responsible for nearly one third of all-cause mortalities
in patients aged 65 years and over, and nearly 90% of deaths from pneumonia are in this patient population.

Additionally, sepsis is known to be associated with advanced age, and chronic complex comorbidities influence and
increase risk.
There are significant changes to homeostasis in all organ systems as the body ages, and the immune system is no

With advanced age, the immune system is impaired both quantitatively and qualitatively, which is
reflected by an increased susceptibility to infection, and a delayed or ineffective recovery.
A protracted illness is not uncommon when an older person experiences infection or sepsis, with the probability of
never fully regaining premorbid functional status. Therefore, a higher level of care is not uncommon as a

Key principles:

  • Infection and sepsis are common causes of morbidity and mortality in the aged care population.
  • Clinical presentations of infection and sepsis are often atypical.
  • The decision to treat locally or transfer is dependent on clinical urgency, patient context and geographical location.
  • Antimicrobial stewardship is a critical aspect of infection and sepsis care.
  • There are particular challenges with infection and sepsis in the residential aged care facility environment.

RACGP aged care clinical guide (Silver Book) Silver Book – Part A Infection and sepsis: GP Guide Infection and Sepsis