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Although the early administration of antibiotics for sepsis is emphasized by multiple guidelines, the recommended timing is inconsistent, with the Surviving Sepsis Campaign recommending administration within 1 hour and the Centers for Medicare & Medicaid Services recommending it within 3 hours of sepsis recognition. This has led to broad antibiotic use, even in the absence of infection, in emergency department (ED) patients.
In a systematic review and meta-analysis of 13 studies with a combined 33,863 patients, investigators compared the effect on mortality of “immediate” (<1 hour) versus “early” (1–3 hours) administration of antibiotics. Overall, the studies were of low quality and the definition of time zero varied from ED triage to signs …