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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.