- patients with evidence (clinical, hematological, microbiological or imaging ) of sepsis or any acute/subacute coinfection at the time of enrollment. - patients who have already received any of the study drugs prior to randomization. - patients with severe renal and/or hepatic impairment (egfr <30 ml/min [epi-ckd formula] or serum alt more than 5 times normal upper limit, serum bilirubin > 2 mg/dl). - patients with known copd. - patients with absolute neutrophil count <700 cells/microliter, 0.7 x 103/microliter. - patients with absolute lymphocyte count <200 cells/microliter, 0.20 x 103/microliter. - patients who are allergic to any of the study drugs. - patients with chronic infections, such as tuberculosis (tb), hiv infection etc. - immunosuppressed patients, such as taking cytotoxic/immunomodulating drugs or systemic steroid.

- patients with evidence (clinical, hematological, microbiological or imaging ) of sepsis or any acute/subacute coinfection at the time of enrollment. - patients who have already received any of the study drugs prior to randomization. - patients with severe renal and/or hepatic impairment (egfr <30 ml/min [epi-ckd formula] or serum alt more than 5 times normal upper limit, serum bilirubin > 2 mg/dl). - patients with known copd. - patients with absolute neutrophil count <700 cells/microliter, 0.7 x 103/microliter. - patients with absolute lymphocyte count <200 cells/microliter, 0.20 x 103/microliter. - patients who are allergic to any of the study drugs. - patients with chronic infections, such as tuberculosis (tb), hiv infection etc. - immunosuppressed patients, such as taking cytotoxic/immunomodulating drugs or systemic steroid.