Delay of appropriate antibiotic treatment is associated with high mortality in patients with community-onset sepsis in a Swedish setting

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Andersson, MariaLinköpings universitet,Avdelningen för mikrobiologi, infektion och inflammation,Medicinska fakulteten (author)

Delay of appropriate antibiotic treatment is associated with high mortality in patients with community-onset sepsis in a Swedish setting

Article/chapterEnglish2019

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2019-03-25
SPRINGER,2019
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:liu-158846
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-158846URI
https://doi.org/10.1007/s10096-019-03529-8DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agencies|County of Ostergotland [2013/466-31]
Early appropriate antimicrobial therapy is crucial in patients with sepsis and septic shock. Studies often focus on time to first dose of appropriate antibiotics, but subsequent dosing is equally important. Our aim was to investigate the impact of fulfillment of early treatment, with focus on appropriate administration of first and second doses of antibiotics, on 28-day mortality in patients with community-onset severe sepsis and septic shock. A retrospective study on adult patients admitted to the emergency department with community-onset sepsis and septic shock was conducted 2012-2013. The criterion early appropriate antibiotic treatment was defined as administration of the first dose of adequate antibiotics within 1h, and the second dose given with less than 25% delay after the recommended dose interval. A high-risk patient was defined as a septic patient with either shock within 24h after arrival or red triage level on admittance according to the Medical Emergency Triage and Treatment System Adult. Primary endpoint was 28-day mortality. Of 90 patients, less than one in four (20/87) received early appropriate antibiotic treatment, and only one in three (15/44) of the high-risk patients. The univariate analysis showed a more than threefold higher mortality among high-risk patients not receiving early appropriate antibiotic treatment. Multivariable analysis identified early non-appropriate antibiotic treatment as an independent predictor of mortality with an odds ratio for mortality of 10.4. Despite that the importance of early antibiotic treatment has been established for decades, adherence to this principle was very poor.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Sepsis; Septic shock; Antibiotics; Mortality; Emergency department

Added entries (persons, corporate bodies, meetings, titles ...)

Östholm Balkhed, ÅseLinköpings universitet,Avdelningen för mikrobiologi, infektion och inflammation,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland(Swepub:liu)aseos46 (author)
Fredrikson, MatsLinköpings universitet,Avdelningen för neuro- och inflammationsvetenskap,Medicinska fakulteten(Swepub:liu)matfr43 (author)
Holmbom, MartinLinköpings universitet,Avdelningen för mikrobiologi, infektion och inflammation,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland(Swepub:liu)marho19 (author)
Hällgren, AnitaLinköpings universitet,Avdelningen för mikrobiologi, infektion och inflammation,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland(Swepub:liu)aniha32 (author)
Berg, SörenLinköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Thorax-kärlkliniken i Östergötland(Swepub:liu)sorbe67 (author)
Hanberger, HåkanLinköpings universitet,Avdelningen för mikrobiologi, infektion och inflammation,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland(Swepub:liu)hakha84 (author)
Linköpings universitetAvdelningen för mikrobiologi, infektion och inflammation (creator_code:org_t)

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In:European Journal of Clinical Microbiology and Infectious Diseases: SPRINGER38:7, s. 1223-12340934-97231435-4373

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