The 2026 Surviving Sepsis Campaign guidelines emphasize early antimicrobial therapy, individualized fluid resuscitation, antimicrobial de-escalation, and avoidance of unproven interventions in adults with sepsis and septic shock. The guidelines recommend prompt antibiotics—ideally within one hour for probable or definite sepsis—along with at least 30 mL/kg of IV crystalloids within three hours for sepsis-induced hypoperfusion or septic shock, with ongoing reassessment to avoid fluid overload.
Routine empirical antifungal and anaerobic coverage is discouraged without specific risk factors, while several unsupported therapies, including IV vitamin C, probiotics, β-blockers and unnecessary kidney replacement therapy, are not recommended. Overall, the update prioritizes rapid treatment, targeted resuscitation, antimicrobial stewardship and evidence-based care.