Objectives: To determine the mortality rate, causes of death, and treatment modalities associated with SAB in middle-income Asia. Methods: A prospective study was conducted over 1 year in a 1000-bed provincial hospital in NE Thailand. Clinical features, treatment, and outcomes were recorded. Results: Among the 98 cases of SAB, overall (52%) and attributable (43%) mortality were high. Mortality was lower in children than adults (32% vs. 64%, p=0.003), with a trend towards increased mortality in patients infected with MRSA versus MSSA (67% vs. 46%, p=0.065). The most common cause of death was septic shock, for which mortality was 65%. Despite the availability of sepsis therapies, administration of these treatments in patients with severe sepsis (n=28) or septic shock (n=49) was low: appropriate empiric antibiotics (54% and 63% respectively), central venous access (14%, 20%), fluid boluses (0%, 39%), vasoactive drugs (4%, 59%), central haemodynamic monitoring (0%, 12%), urinary catheterisation (21%, 63%), glucose monitoring (54%, 51%), insulin sliding scale (7%, 12%) and mechanical ventilation (18%, 65%) or supplemental oxygen (48%, 65%). Additionally, interventions were rarely targeted to resuscitation goals and volumes of intravenous fluid given were sub-optimal. Conclusions: Attributable mortality of SAB in this study is significantly higher than that commonly reported from industrialised nations. SAB-associated deaths are usually due to septic shock but use of appropriate antibiotics, fluids, and haemodynamic support is inadequate. These data support the development of an algorithm to aid early recognition of septic patients and to optimise goal-directed interventions within the resource capabilities of the tropical setting.