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*

By D. Gaieski, M. Mikkelsen, R. Band, J. Pines, R. Massone, Frances F Furia, F. Shofer, M. Goyal. Critical Care Medicine, 2010

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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 (2017, result): “Despite a meta-analysis of mostly poorquality studies that failed to demonstrate a benefit of rapid antimicrobial therapy, the largest and highest-quality studies support giving appropriate antimicrobials as soon as possible in patients with sepsis with or without septic shock [57, 74, 79-81].”
Empiric Antibiotic Treatment Reduces Mortality in Severe Sepsis and Septic Shock From the First Hour: Results From a Guideline-Based Performance Improvement Program* (2014, background): “In a study of 261 patients in the ED, Gaieski et al (13) confirmed the association with timing of antibiotic therapy and mortality in patients with severe sepsis or septic shock.”
The Timing of Early Antibiotics and Hospital Mortality in Sepsis (2017, background): “While no one recommends delaying antibiotics for sepsis patients, the existing evidence supporting the mortality benefits of earlier antibiotic administration is mixed.(14-30, 32) In a frequently cited study, Kumar and others retrospectively evaluated 2,154 critically ill patients with septic shock ”