Mortality Does Not Increase with Time from Shock Diagnosis to Antibiotic Administration

International consensus guidelines that recommend broad-spectrum antibiotics within the first hour of septic shock recognition are based largely on a single retrospective study that included intensive care unit patients with high mortality (56%). To determine appropriate guidelines for the emergency department (ED) setting, researchers performed a planned analysis of a randomized, controlled trial of 291 consecutive adult patients with septic shock who were treated with a standardized quantitative resuscitation protocol for up to 6 hours in three urban U.S. EDs. All patients received broad-spectrum antibiotics per local hospital guidelines.

Median time from triage to initial antibiotics was 115 minutes (interquartile range, 65–175 minutes). …