Bottom line: Administering antibiotics within one hour after triaging significantly decreases mortality in patients admitted to the ED with sepsis.
Summary: Gaieski DF, et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med. 2010 Apr;38(4):1045-53.
Objective: To study the association between time to antibiotic administration and survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Methods: Cohort study of 261 patients in a tertiary care hospital 2005-2006 who received early goal-directed therapy (EGDT – algorithmic volume resuscitation, placement of central venous catheter, and measurement of central venous pressure, mean arterial pressure, and ScvO2) during ED stay and who were included in the severe sepsis and septic shock database. Results: Table 6 (p. 1048) compares in-hospital mortality for various cut-offs of time from triage to appropriate antibiotics. Greatest difference in probability of mortality between the group receiving antibiotics <1 hour after triage (0.13) and those receiving antibiotics ≥ 1hour after triage (0.29).
Repost of 5/11/10