The impact of emergency antibiotic administration time on patients with sepsis

OBJECTIVES: To assess the mortality benefits of timely antibiotic treatment of adults present at the emergency department with sepsis and compare one-hour administration and 3-hour administration starting from the time of triage. METHODS: In this retrospective study, we used secondary data analysis to investigate the utility of the National Early Warning Score as a predictor of mortality in sepsis patients between July 2018 and June 2019, at the Emergency Department, King Saud Medical City, Riyadh, Saudi Arabia. The patients were grouped into 2 based on the time interval from triage to the first antibiotic administration: the immediate group received antibiotics within the first hour, and the early group received antibiotics between one and 3 hours. The primary outcome of interest was in-hospital mortality. RESULTS: Out of 495 septic patients, only 292 patients (mean age of 56.3 ± 23.6 years) met the inclusion criteria. Two hundred fifty (85.6%) patients received antibiotics within one hour of triage (immediate), while 42 (14.4%) patients received antibiotics between one and 3 hours (early). Overall, in-hospital mortality was 31.8%. The mortality rates among patients who received early antibiotic was 31.6% and who received immediate antibiotic was 33.3%, with a p-value of 0.823. CONCLUSION: Our findings did not support immediate antibiotic administration over early administration in patients with sepsis. However, further studies are recommended to investigate the effects of antibiotic timing on the outcome of severe sepsis patients.