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    Home > Active Ingredient News > Infection > Is the timing of antibiotics consistent in sepsis and septic shock?

    Is the timing of antibiotics consistent in sepsis and septic shock?

    • Last Update: 2022-03-08
    • Source: Internet
    • Author: User
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    Introduction It is well known that timely administration of antibiotics is one of the most important interventions to reduce sepsis mortality
    .

    However, administering antibiotics to all patients with suspected sepsis within strict time thresholds would require significant manpower and resources and may increase the risk and consequences of unintentional exposure to broad-spectrum antibiotics in uninfected patients
    .

    Therefore, there is still debate as to whether clinicians should use different thresholds of antibiotic use in patients with sepsis and septic shock
    .

    Recently, the journal Crit Care published a prospective nationwide multicenter cohort study to examine the association between duration of antibiotic use and clinical outcomes in patients with sepsis and septic shock
    .

    Study Overview Investigators conducted a prospective analysis of data collected from an ongoing multicenter emergency department cohort of patients with confirmed sepsis and compared hospitalizations in patients who received antibiotics within 1 hour versus those who did not.
    Adjusted odds ratios (ORs) for mortality
    .

    The study also assessed the association between duration of antibiotic use (as a continuous variable) and an increased risk of in-hospital mortality and differences in the association between duration of antibiotic use and in-hospital mortality based on the presence or absence of septic shock
    .

    A total of 3035 patients were included in the analysis
    .

    Of these, 601 (19.
    8%) had septic shock and 774 (25.
    5%) died
    .

    The results showed: ➤ The adjusted OR for in-hospital mortality of patients with antibiotic use within 1 hour was 0.
    78 (95% confidence interval [CI] 0.
    61-0.
    99; p = 0.
    046)
    .

    The adjusted OR for in-hospital mortality was 0.
    66 (95% CI 0.
    44-0.
    99; p = 0.
    049) in patients with septic shock and 0.
    85 (95% CI 0.
    64-1.
    15) in patients with sepsis without shock ; p = 0.
    300)
    .

    ➤ In patients who received antibiotics within 3 hours, each 1-hour delay in antibiotics in septic shock patients increased the risk of death by 35% (p = 0.
    042), but this was not observed in septic patients without shock.
    trend
    .

    CONCLUSIONS: Prompt administration of antibiotics improves outcomes in patients with septic shock; however, in septic patients without shock, the association between early antibiotic administration and patient outcomes is unclear
    .

    Compiled by: Im Y, Kang D, Ko RE, Lee YJ, Lim SY, Park S, Na SJ, Chung CR, Park MH, Oh DK, Lim CM, Suh GY; Korean Sepsis Alliance (KSA) investigators.
    Time-to-antibiotics and clinical outcomes in patients with sepsis and septic shock: a prospective nationwide multicenter cohort study.
    Crit Care.
    2022 Jan 13;26(1):19.
    doi: 10.
    1186/s13054-021-03883-0.
    PMID : 35027073; PMCID: PMC8756674.

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