J Korean Soc Emerg Med.  2015 Feb;26(1):89-94. 10.0000/jksem.2015.26.1.89.

Early Antibiotic Administration and Mortality in Patients with Septic Shock in Emergency Department

• Lee YJ
• Ryoo SM
• Oh SH
• Ko BS
• Sohn CH
• Ahn S
• Seo DW
• Lee YS
• Lim KS
• Kim WY

• KMID: 2191839
• DOI: http://doi.org/10.0000/jksem.2015.26.1.89

Abstract

PURPOSE
The Surviving Sepsis Campaign recommend initiating broad spectrum antibiotics within the first hour of recognition of septic shock. An unknown proportion of the effectiveness of earlier antibiotics administration will remain in septic shock patients treated with an early quantitative resuscitation in emergency department (ED). We were to compare the 28-day mortality between earlier antibiotic administration (< or =1 hour) and early antibiotic administration (1 hour to 6 hour) in septic shock patients in ED.
METHODS
A total of 536 consecutive septic shock patients were prospectively collected from January 2010 to June 2012. We identified 357 patients who were developed shock at initial assessment, and measured the time of initial antibiotics administration. The primary outcome was 28-day mortality.
RESULTS
Mean age was 62.8+/-13.7 years old and 222 patients were male (62.2%). The median time from shock recognition-to-antibiotics administration was 94.0 min (IQR 47.0-150.0) and 28-day mortality rate was 20.2%. When the relationship of 28-day mortality between earlier antibiotic administration (< or =1 hour) and early antibiotic administration (1 hour to 6 hour) was compared, no significant difference was shown (19.5% vs. 20.5%, p=0.82).
CONCLUSION
Earlier antibiotics administration may have no additional outcome value in septic shock patients treated with an early quantitative resuscitation in ED.

Keyword

Antibiotics; Sepsis; Treatment outcome

MeSH Terms

Anti-Bacterial Agents
Emergency Service, Hospital*
Humans
Male
Mortality*
Prospective Studies
Resuscitation
Sepsis
Shock
Shock, Septic*
Treatment Outcome
Anti-Bacterial Agents