One of the hardest parts of working in pharmacy isn’t dealing with medicines.
It’s hearing what happened afterwards.
Every now and then someone will come to collect a prescription and casually say, “Dad’s still in hospital.”
“What happened?”
“They said it was sepsis.”
That word seems to have appeared in the news much more over the last few years, yet many people still don’t really know what it means.
Some think it’s a type of infection.
It isn’t.
Sepsis is the body’s overwhelming response to an infection. Instead of fighting the germs in a controlled way, the immune system goes into overdrive. Chemicals released into the bloodstream begin damaging the body’s own tissues and organs. Blood pressure can fall, oxygen struggles to reach vital organs, and without urgent treatment, the kidneys, lungs, heart and brain can all start to fail.
In simple terms, it’s your own defence system becoming so aggressive that it starts harming the person it’s trying to protect.
That’s why sepsis is a medical emergency.
The infection that triggers it can be surprisingly ordinary.
A urine infection.
A chest infection.
An infected wound.
A skin infection.
Even a small cut can occasionally become the starting point, although thankfully this is uncommon.
Most infections never develop into sepsis, but every case of sepsis starts with an infection.
As pharmacists, we often see those infections first.
Someone comes in with a painful cough that’s getting worse.
An elderly gentleman says he’s passing urine every hour and it burns.
A lady shows us a red swollen leg that has become hot to touch.
Most of the time, these infections are treated successfully.
Occasionally, they aren’t.
One thing I’ve learnt is that older people don’t always become obviously ill.
Instead of complaining about pain, they suddenly become confused.
A normally chatty customer may seem unusually sleepy or struggle to answer simple questions.
Family members sometimes say, “They’ve just not been themselves today.”
Never ignore that sentence.
Confusion in an older adult with an infection should always ring alarm bells.
Children can be different again.
They may become unusually drowsy, difficult to wake, floppy, or stop feeding.
These are not symptoms to “sleep off.”
Another misunderstanding is that sepsis always comes with a very high temperature.
It often does.
But not always.
Some people with severe sepsis actually have a low body temperature.
Others don’t look desperately ill until they suddenly deteriorate.
That’s why healthcare professionals look at the whole picture—breathing rate, heart rate, blood pressure, oxygen levels, mental state and the source of the infection.
People often ask me whether antibiotics prevent sepsis.
The answer is yes—if they’re needed and started early enough.
Antibiotics kill bacteria, reducing the chance of an infection spreading through the body.
But they’re not the answer to every cough or sore throat, especially when the cause is viral.
That’s why pharmacists and doctors don’t hand out antibiotics “just in case.”
Using them unnecessarily fuels antibiotic resistance, making them less effective when they’re genuinely needed.
When sepsis is suspected, though, every minute counts.
Treatment usually involves intravenous antibiotics, fluids, oxygen and careful monitoring in hospital. Some patients need intensive care.
The encouraging news is that many people make a good recovery when sepsis is recognised and treated promptly.
The problem is delay.
People often wait because they think, “Let’s see how I am tomorrow.”
Sometimes tomorrow is too late.
As pharmacists, we spend a lot of time talking about medicines.
But sometimes the most important advice we give has nothing to do with tablets.
It’s recognising when an infection is no longer “just an infection.”
If someone with an infection becomes confused, struggles to breathe, is difficult to wake, develops mottled or bluish skin, or seems rapidly worse than expected, don’t wait for the pharmacy to open in the morning.
Seek urgent medical attention immediately.
Most infections get better.
The small number that don’t deserve to be taken seriously.
That knowledge could save a life.
Until next time, stay well, stay informed, and never ignore your instincts when someone suddenly becomes much more unwell than you’d expect
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