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J Korean Soc Emerg Med > Volume 26(1); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(1): 89-94.
Early Antibiotic Administration and Mortality in Patients with Septic Shock in Emergency Department
You Jin Lee, Seung Mok Ryoo, Se Hyun Oh, Byuk Sung Ko, Chang Hwan Sohn, Shin Ahn, Dong Woo Seo, Yoon Seon Lee, Kyoung Soo Lim, Won Young Kim
Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. emosh89@gmail.com
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.
Key words: Antibiotics, Sepsis, Treatment outcome
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