Cargando…

Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department

OBJECTIVE: We aimed to investigate the effect of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock. METHODS: We analyzed data from a sepsis registry that included adult patients who initially presented to the emergency department (ED) and met criteria for s...

Descripción completa

Detalles Bibliográficos
Autores principales: Joo, Young Min, Chae, Minjung Kathy, Hwang, Sung Yeon, Jin, Sang-Chan, Lee, Tae Rim, Cha, Won Chul, Jo, Ik Joon, Sim, Min Seob, Song, Keun Jeong, Jeong, Yeon Kwon, Shin, Tae Gun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Emergency Medicine 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052817/
https://www.ncbi.nlm.nih.gov/pubmed/27752550
http://dx.doi.org/10.15441/ceem.14.012
_version_ 1782458292651425792
author Joo, Young Min
Chae, Minjung Kathy
Hwang, Sung Yeon
Jin, Sang-Chan
Lee, Tae Rim
Cha, Won Chul
Jo, Ik Joon
Sim, Min Seob
Song, Keun Jeong
Jeong, Yeon Kwon
Shin, Tae Gun
author_facet Joo, Young Min
Chae, Minjung Kathy
Hwang, Sung Yeon
Jin, Sang-Chan
Lee, Tae Rim
Cha, Won Chul
Jo, Ik Joon
Sim, Min Seob
Song, Keun Jeong
Jeong, Yeon Kwon
Shin, Tae Gun
author_sort Joo, Young Min
collection PubMed
description OBJECTIVE: We aimed to investigate the effect of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock. METHODS: We analyzed data from a sepsis registry that included adult patients who initially presented to the emergency department (ED) and met criteria for severe sepsis or septic shock. Timely antibiotic use was defined as administration of a broad-spectrum antibiotic within three hours from the time of ED arrival. Multivariable logistic and linear regression analyses were performed to assess associations between timely administration of antibiotics and outcomes, including hospital mortality, 48-hour change in Sequential Organ Failure Assessment (SOFA) score (delta SOFA), and hospital length of stay (LOS). RESULTS: A total of 591 patients were included in the study. In-hospital mortality was 16.9% for patients receiving timely antibiotics (n=377) and 22.9% for patients receiving delayed antibiotics (n=214; P=0.04). The adjusted odds ratio for in-hospital survival was 0.54 (95% confidence interval [CI], 0.34 to 0.87; P=0.01) in patients who received timely antibiotics. Timely antibiotic administration was also significantly associated with higher delta SOFA (2 vs. 1) and shorter hospital LOS among survivors (11 days vs. 15 days). Multivariable linear regression analyses showed that timely antibiotic administration was significantly associated with increased delta SOFA and decreased hospital LOS. CONCLUSION: Antibiotic administration within three hours from the time of ED arrival was significantly associated with improved outcomes, including in-hospital survival, reversal of organ failure, and shorter hospital LOS, in patients with severe sepsis and septic shock.
format Online
Article
Text
id pubmed-5052817
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher The Korean Society of Emergency Medicine
record_format MEDLINE/PubMed
spelling pubmed-50528172016-10-17 Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department Joo, Young Min Chae, Minjung Kathy Hwang, Sung Yeon Jin, Sang-Chan Lee, Tae Rim Cha, Won Chul Jo, Ik Joon Sim, Min Seob Song, Keun Jeong Jeong, Yeon Kwon Shin, Tae Gun Clin Exp Emerg Med Original Article OBJECTIVE: We aimed to investigate the effect of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock. METHODS: We analyzed data from a sepsis registry that included adult patients who initially presented to the emergency department (ED) and met criteria for severe sepsis or septic shock. Timely antibiotic use was defined as administration of a broad-spectrum antibiotic within three hours from the time of ED arrival. Multivariable logistic and linear regression analyses were performed to assess associations between timely administration of antibiotics and outcomes, including hospital mortality, 48-hour change in Sequential Organ Failure Assessment (SOFA) score (delta SOFA), and hospital length of stay (LOS). RESULTS: A total of 591 patients were included in the study. In-hospital mortality was 16.9% for patients receiving timely antibiotics (n=377) and 22.9% for patients receiving delayed antibiotics (n=214; P=0.04). The adjusted odds ratio for in-hospital survival was 0.54 (95% confidence interval [CI], 0.34 to 0.87; P=0.01) in patients who received timely antibiotics. Timely antibiotic administration was also significantly associated with higher delta SOFA (2 vs. 1) and shorter hospital LOS among survivors (11 days vs. 15 days). Multivariable linear regression analyses showed that timely antibiotic administration was significantly associated with increased delta SOFA and decreased hospital LOS. CONCLUSION: Antibiotic administration within three hours from the time of ED arrival was significantly associated with improved outcomes, including in-hospital survival, reversal of organ failure, and shorter hospital LOS, in patients with severe sepsis and septic shock. The Korean Society of Emergency Medicine 2014-09-30 /pmc/articles/PMC5052817/ /pubmed/27752550 http://dx.doi.org/10.15441/ceem.14.012 Text en Copyright © 2014 The Korean Society of Emergency Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).
spellingShingle Original Article
Joo, Young Min
Chae, Minjung Kathy
Hwang, Sung Yeon
Jin, Sang-Chan
Lee, Tae Rim
Cha, Won Chul
Jo, Ik Joon
Sim, Min Seob
Song, Keun Jeong
Jeong, Yeon Kwon
Shin, Tae Gun
Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
title Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
title_full Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
title_fullStr Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
title_full_unstemmed Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
title_short Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
title_sort impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052817/
https://www.ncbi.nlm.nih.gov/pubmed/27752550
http://dx.doi.org/10.15441/ceem.14.012
work_keys_str_mv AT jooyoungmin impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT chaeminjungkathy impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT hwangsungyeon impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT jinsangchan impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT leetaerim impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT chawonchul impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT joikjoon impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT simminseob impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT songkeunjeong impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT jeongyeonkwon impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment
AT shintaegun impactoftimelyantibioticadministrationonoutcomesinpatientswithseveresepsisandsepticshockintheemergencydepartment