Timely antibiotics after triage cuts mortality from septic shock

  • Ko BS & al.
  • Am J Med
  • 14 Oct 2019

  • International Clinical Digest
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Takeaway

  • Decreased in-hospital mortality is seen in patients with septic shock who receive antibiotics within 1 hour of emergency department (ED) triage.

Why this matters

  • Previous studies have shown mixed results for associations between antibiotic administration timing and septic shock treatment outcomes.

Study design

  • Researchers analysed septic shock treatment data collected from 10 EDs (N=2250; mean age, 67.9 years; men, 58.4%) to assess associations between various intervals from triage to first antibiotic administration (≤1 hour, 1-2 hours, 2-3 hours, and >3 hours) and in-hospital mortality.
  • Funding: Korean Ministry of Science and Information and Communication Technology; National Research Foundation of Korea.

Key results

  • Overall in-hospital mortality was 22.8%; median time to first antibiotic administration was 2.29 hours.
  • Among patients who received first antibiotics within 1-2 hours or >3 hours of triage, in-hospital mortality was significantly higher than in those who received them within 1 hour (OR, 1.248 [P=.011]; and OR, 1.419 [P<.001 respectively but this was not true for patients who received first antibiotics between and hours p=".052).</span">

Limitations

  • This was a nonrandomised registry study.
  • Unmeasured confounders may have affected the results.
  • Outcomes varied by hospital.

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