Multisystem Inflammatory Syndrome (MIS-C) Clinical Pathway — Emergency, ICU and Inpatient
Antibiotics and Anti-Virals
Antibiotics
- Initiate empiric broad-spectrum antibiotics for patients that present with shock and in whom there is concern for sepsis per usual clinical care standards.
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- Presentation of MIS-C overlaps with various causes of bacterial sepsis (e.g., toxic shock syndrome)
- Obtain bacterial cultures prior to treatment as able.
- Discuss duration of antibiotic treatment with ID
- Consider discontinuing after 48 hrs if bacterial cultures are negative and no other evidence of bacterial infection
Antivirals
- MIS-C is a post-infectious inflammatory process, not the direct result of the SARS-CoV-2 viral replication.
- Antivirals are generally not indicated, even if the nasopharyngeal PCR test is positive.