Which action is not part of initial protocol in suspected sepsis management?

• A. Administer broad-spectrum antibiotics
• B. Initiate IV fluids
• C. Obtain cultures
• D. Withhold antibiotics to wait for culture results

Answer: (D)

In suspected sepsis, the priority is rapid treatment to prevent organ failure and death. The main actions are to start broad-spectrum antibiotics as soon as sepsis is suspected and to begin aggressive IV fluid resuscitation to restore perfusion. Cultures are obtained promptly to identify the offending organism, which helps tailor therapy later, but treatment should not wait for those results. The reason is that every hour of delay in appropriate antibiotics increases mortality risk in sepsis. So, withholding antibiotics until culture results are back contradicts the urgent need for immediate antimicrobial therapy; cultures can be drawn at the same time as antibiotics are started or immediately beforehand if it does not cause delays.