Delayed Administration of Antibiotics and Sepsis Mortality, Revisited

Studies of sepsis and septic shock have shown that delayed administration of appropriate antibiotics adversely affects mortality. Research has focused on rapid, accurate identification of septic patients rather than on factors that delay antibiotic administration. A recent retrospective cohort study involving 4429 consecutive patients with new-onset sepsis or septic shock at a single academic tertiary care referral center sheds some light on this issue.

From patient records, the investigators determined the “door to order time” (DTOT) from entry into the emergency department to the order for antibiotics and the “antimicrobial lead time” (ALT) from the doctors' order to the first antibiotic administration.

Mortality increased significantly wit…