Antibiotics in Sepsis: Is Very Early Use Best?

In a retrospective review of 35,000 patients, mortality increased with each hour of delay in antibiotic administration, particularly in those with septic shock.

It is accepted dogma that giving antibiotics as early as possible in patients with sepsis leads to an improved outcome. However, there are harms with this approach, including overuse and misuse of antibiotics. To explore this issue further, investigators conducted a retrospective review of adult patients with sepsis seen at Kaiser Permanente Northern California healthcare from July 2010 through December 2013. From this group, 5000 patients seen in 2010 were randomly selected, and 10,000 patients were chosen at random from each subsequent year. The patient's clinical status from the first hour in the emergency department (ED) was used as a baseline.

Among the 35,000 subjects in the sample, 4668 (13%) met the criteria for septic shock and 18,2…

Reviewing Author

Neil M. Ampel, MD

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Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Antibiotics in Sepsis: Is Very Early Use Best?

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Reviewing Author