Observational studyCritical care (London, England)2014
Impact of compliance with infection management guidelines on outcome in patients with severe sepsis: a prospective observational multi-center study.
Observational study in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 91 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Medical Education for Sepsis Source Control and Antibiotics
Trial of Antimicrobial Restraint in Presumed Pneumonia
Who cites it
91 citing papers in PubMed, 6 syntheses or guidelines pooled it, 236 citations in OpenAlex.
- Appropriate timing of antibiotic initiation in patients with sepsis or septic shock: a systematic review and meta-analysis.The Korean journal of internal medicine · 2025Pooled it
- Early management of adult sepsis and septic shock: Korean clinical practice guidelines.Acute and critical care · 2024Guideline
- [Early source control of infection in patients seen in the emergency department: a systematic review].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Pooled it
- Exploring the content and delivery of feedback facilitation co-interventions: a systematic review.Implementation science : IS · 2024Pooled it
- [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Guideline
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Risk factors for therapeutic failure in the management of post-operative peritonitis: a post hoc analysis of the DURAPOP trial.The Journal of antimicrobial chemotherapy · 2021Trial
- Fever and hypothermia represent two populations of sepsis patients and are associated with outside temperature.Critical care (London, England) · 2021Trial
- Influence of pathogen and focus of infection on procalcitonin values in sepsis patients with bacteremia or candidemia.Critical care (London, England) · 2018Trial
- The German Quality Network Sepsis: study protocol for the evaluation of a quality collaborative on decreasing sepsis-related mortality in a quasi-experimental difference-in-differences design.Implementation science : IS · 2018Trial
- Effect of a multifaceted educational intervention for anti-infectious measures on sepsis mortality: a cluster randomized trial.Intensive care medicine · 2017Trial
- Physiological Data Integration and Predictive Modeling in Intensive Care.Life (Basel, Switzerland) · 2026Review
- Clinical Features and 1-Year Prognosis of Patients with Suspected Sepsis and Positive Blood Cultures in the Emergency Department: A Single-Center Retrospective Study.Medicina (Kaunas, Lithuania) · 2026Article
- Admission lipid profile and outcomes in sepsis requiring early invasive source control.BMC infectious diseases · 2026Observational
- Article
- Adoption of a novel biomarker-guided quality improvement treatment bundle for patients with subclinical acute kidney injury after cardiac surgery: An implementation study.European journal of anaesthesiology · 2026Article
- [Sepsis care in Germany: quality indicators on diagnostics and treatment of sepsis].Die Anaesthesiologie · 2026Article
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- Antibiotic Resistance Pattern and Surgical Outcome in Complicated Intra-Abdominal Infections Due to Colorectal Perforation.Antibiotics (Basel, Switzerland) · 2026Article
- Personalized Approaches to Patients with Intra-Abdominal Infections.Journal of clinical medicine · 2025Review
31 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
24 authors at 15 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCurrent sepsis guidelines recommend antimicrobial treatment (AT) within one hour after onset of sepsis-related organ dysfunction (OD) and surgical source control within 12 hours. The objective of this study was to explore the association between initial infection management according to sepsis treatment recommendations and patient outcome.
methodsIn a prospective observational multi-center cohort study in 44 German ICUs, we studied 1,011 patients with severe sepsis or septic shock regarding times to AT, source control, and adequacy of AT. Primary outcome was 28-day mortality.
resultsMedian time to AT was 2.1 (IQR 0.8 - 6.0) hours and 3 hours (-0.1 - 13.7) to surgical source control. Only 370 (36.6%) patients received AT within one hour after OD in compliance with recommendation. Among 422 patients receiving surgical or interventional source control, those who received source control later than 6 hours after onset of OD had a significantly higher 28-day mortality than patients with earlier source control (42.9% versus 26.7%, P <0.001). Time to AT was significantly longer in ICU and hospital non-survivors; no linear relationship was found between time to AT and 28-day mortality. Regardless of timing, 28-day mortality rate was lower in patients with adequate than non-adequate AT (30.3% versus 40.9%, P < 0.001).
conclusionsA delay in source control beyond 6 hours may have a major impact on patient mortality. Adequate AT is associated with improved patient outcome but compliance with guideline recommendation requires improvement. There was only indirect evidence about the impact of timing of AT on sepsis mortality.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.