Give Antibiotics Quickly for Severe Sepsis and Septic Shock

Kristi L. Koenig, MD, FACEP, FIFEM

Probability of death steadily increased with each hour's delay to antibiotics.

Rapid administration of antibiotics is essential in patients with severe sepsis and septic shock. Researchers retrospectively analyzed data from the Surviving Sepsis Campaign for 17,990 septic patients who received antibiotics in 165 intensive care units in Europe, the United States, and South America over a 5-year period.

The adjusted odds ratio for hospital mortality increased linearly with each 1-hour delay in antibiotic administration, from 1.00 when time to antibiotics was less than 1 hour to 1.52 when time to antibiotics was more than 6 hours. The researchers predicted that for a patient admitted from a U.S. emergency department with a sepsis severity score of 52, the probability of mortality would increase from 25% when antibiotics were given within 1 hour to 33% when antibiotics were delayed for 6 hours.

Citation(s):

Ferrer R et al. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: Results from a guideline-based performance improvement program. Crit Care Med 2014 Apr 8; [e-pub ahead of print].