1 medication principles: ① early medication, especially for the more serious or weak infants, as soon as there are suspicious signs of sepsis, the necessary effective treatment should be made, do not wait for the test results and delay treatment. ②The course of treatment should be sufficient, generally 10 to 14 days, and those with complications should be treated for more than 3 weeks. (③) Intravenous antibiotics should be given as much as possible. ④Neonates should be given less frequently because of immature liver and kidney function, especially preterm infants within 1 week should be given once every 12-24 hours, and once every 8-12 hours after 1 week. ⑤ Pay attention to the toxic side effects of drugs. Ceftazidime, cefoperazone and ceftazidime are easy to affect the coagulation mechanism, so be alert to the occurrence of bleeding when using them. 2.Symptomatic supportive treatment: In critically ill children, disorders of circulatory function and internal environment often occur, and symptomatic supportive treatment needs to be implemented in time to maintain normal heart, lung and brain function and stability of the internal environment of the child. The main keys of symptomatic supportive treatment are: ① Maintain vital signs, timely correction of hypoxemia and acidosis. (2) expand the volume when the peripheral circulation is poor, and whole blood or plasma can be given to maintain blood pressure, blood sugar and water and electro-mediated balance. ③Treat symptomatically, give antipyretics and use physical cooling when the body temperature is too high. If convulsions occur, give sedatives and consider artificial hibernation therapy if necessary. Promptly treat cerebral edema, DIC, and hyperbilirubinemia. ④ Thoroughly purge the primary lesions and discover new migratory lesions early and remove them completely at any time to eliminate the source of pathogenic bacteria, such as umbilicus, skin infection foci, mucosal ulcers or other sites of septic lesions. ⑤ Improve body resistance and strengthen supportive therapy. Children with weakness, many migratory lesions and severe disease should receive multiple transfusions of blood, plasma, albumin or gammaglobulin, and adequate caloric, fluid and nutritional needs should be ensured. (6) Thoughtful and meticulous care. (7) If the symptoms of infection poisoning are severe, adrenocorticotropic hormone can be given for a short course (3-5 days) along with the application of effective antibiotics in sufficient quantity. The hormone has the effect of strengthening the contractility of the heart and stabilizing the lysosomal membrane, which can resist the damage of bacterial toxins, but because it can cause the development and spread of occult infection foci in the body, it must be combined with an adequate amount of effective antibiotics. Therefore, the addition of this therapy should be considered thoroughly and carefully before use. 2.3 Choice of antibiotics Antibiotics are the key drug for the treatment of sepsis, and effective antibiotics should be used early to destroy all bacteria in the blood as soon as possible. If antibiotics are used improperly, every easy to cause various difficulties, such as the generation of drug-resistant strains and the dysbiosis of various flora in the body, the impact on the diagnosis, treatment and prognosis of various bacterial infections, etc., the choice of antibiotics must be carefully and comprehensively considered. When the pathogenic bacteria is unknown, the selection of drugs can be based on the pathway of bacterial human invasion, the age of the child, clinical manifestations, combined with the epidemiological characteristics of local strains and drug-resistant strains to decide, usually intravenous application of broad-spectrum antibiotics, or for gram-positive cocci and gram-negative bacilli combination of drugs, and later can be adjusted according to the culture and drug sensitivity test results. The general principle of antibiotic treatment of sepsis is that once the diagnosis is suspected to be early, immediately empirical selection of antibiotics that may be effective and less toxic side effects, after the return of clear drug sensitivity test results of pathogenic bacteria, if the preferred antibiotics have been used for 3-5 days poor effect, can be changed according to the results of drug sensitivity test, if the preferred antibiotics are clinically effective, even if the results of drug sensitivity test is not sensitive, there is no need to change the drug. 2.1 Gram-positive cocci, such as Staphylococcus aureus infection is appropriate to use benzathine penicillin, cephalosporin, vancomycin and other drugs, often combined with more than 2 kinds of intravenous drug delivery. 2.2 Gram-negative bacilli, such as Escherichia coli, pneumonia bacillus infection can be used in combination with the 3rd generation cephalosporins and ampicillin, Pseudomonas aeruginosa infection with ceftizoxime and carbenicillin combination. Although aminoglycoside antibiotics (such as butamycin, gentamicin, etc.) have good bactericidal effect, but because of ototoxicity and nephrotoxicity, the new pharmacopoeia stipulates that it is prohibited for children under 6 years old, if it must be applied, it is necessary to fully communicate with parents, inform them of the advantages and disadvantages, and only after parents sign and agree to use it; after application, it is also necessary to closely observe otorrho-renal toxicity, and regularly check hearing and urinary routine. 2.3 For anaerobic infections, metronidazole in combination with penicillin or chloramphenicol is preferred. Chloramphenicol can inhibit bone marrow hematopoietic function and cause “gray baby syndrome” in newborns, so it should be used only after parents’ signature. 2.4 Cefodizime is a new type of β-lactamase-resistant third-generation cephalosporin, which is the only antibiotic with both broad-spectrum and powerful antibacterial and immunomodulatory activities, and has good antibacterial effects on both Gram-positive and negative bacteria, and has little toxic side effects. It has shown good efficacy in the clinical application of anti-infection in infants and children. 2.5 The combination of β-lactamase inhibitors such as trimethoprim, clavulanic acid, sulbactam and tazobactam with antibiotics can often improve the efficacy, but attention should also be paid to the possible increase in toxic side effects. 2.6 In case of septic lesions, surgical incision and drainage or puncture and drainage of pus should be performed along with systemic application of antibiotics. 3, efficacy evaluation sepsis for pediatric acute infectious diseases, rapid changes in the condition, clinical symptoms are not typical, in the implementation of therapeutic measures, more closely observed, timely access to objective and accurate clinical data, with a scientific attitude specific analysis of specific problems, continuous observation of changes in the condition and the patient’s response to treatment, timely analysis, summary, revised treatment, until the patient is cured. In general, if the selected antibiotics can effectively kill the child’s infected bacteria, coupled with timely and appropriate symptomatic support treatment, the child’s condition should improve within 3 to 5 days, otherwise, timely consideration should be given to adjusting the treatment plan to avoid aggravation of the child’s condition and adverse consequences. When a child with sepsis still has a high temperature and no improvement in general condition after anti-infection and symptomatic treatment for complications, and the general condition does not improve despite adjustment of medication by blood culture and drug sensitivity test, the following should be considered: ① The causative organism may be drug-resistant bacteria, although the in vitro drug sensitivity test is sensitive antibiotics, but the in vivo effect is poor, which may be related to the dose, time and mode of administration. ②Whether other bacterial or viral infections are combined. ③Whether there are other complications or migrating lesions. ④Inadequate control of the underlying disease that exists in itself. ⑤Whether there is immune dysfunction, especially in malnourished pediatric patients. ⑥Actively search for etiology and the presence of nosocomial infections, especially medical factors. In case of the above, further detailed medical history should be pursued, comprehensive and integrated analysis of the child’s clinical data, and timely and appropriate adjustment of the treatment plan. 4, prevention and prognosis Common infectious diseases in children such as measles, influenza, whooping cough, etc. are prone to secondary heavy respiratory bacterial infections, resulting in sepsis, for such children, we must strengthen protection. Avoid damage to the skin and mucous membranes as much as possible, detect and treat infectious lesions in a timely manner, and reduce the occurrence of sepsis if all obvious or hidden septic lesions are removed early. All kinds of treatment operations should strictly enforce the aseptic requirements and do not abuse antibiotics or adrenal corticosteroids. Continuous improvement of environmental hygiene, personal hygiene, nutritional status and pediatric health care will hopefully reduce the incidence of pediatric sepsis. The main factors affecting the prognosis are the age of the child, the nutritional status, the sensitivity of the pathogenic bacteria to antibacterial drugs, and the early or late start and thoroughness of treatment. Generally speaking, the prognosis is poor for young age, poor nutritional status, pathogenic bacteria insensitivity to antibacterial drugs, and the occurrence of shock and DIC. Timely, correct and thorough treatment is the main key to a good outcome.