ArticleAmerican journal of respiratory and critical care medicine2017
The Timing of Early Antibiotics and Hospital Mortality in Sepsis.
Article in American journal of respiratory and critical care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 500 papers, 10 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.
EMS Prehospital Blood Culture Collection and Antibiotic Administration: A Two-Phase Pilot Project to Reduce Mortality in Patients With Severe Sepsis and Septic Shock
Effect of Antibiotic Choice On ReNal Outcomes (ACORN)
Risk Factors for Multidrug Resistant Bacteria at ICU Admission
Who cites it
500 citing papers in PubMed, 10 syntheses or guidelines pooled it, 973 citations in OpenAlex.
- A Systematic Review and Meta-analysis of Externally Validated Epic Clinical Decision Support Tools.Journal of general internal medicine · 2026Pooled it
- Efficacy and Safety of Procalcitonin-Guided Antibiotic Therapy versus Standard of Care for Sepsis: A Systematic Review and Meta-Analysis.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2026Pooled it
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- LINC02363: a potential biomarker for early diagnosis and treatment of sepsis.BMC immunology · 2025Pooled it
- Consistency between metagenomic next-generation sequencing versus traditional microbiological tests for infective disease: systemic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Timing of antibiotic initiation in sepsis and neutropenic fever.Frontiers in medicine · 2025Pooled it
- Bibliometric analysis of sepsis and gut microbiota: Trends from 2014 to 2024.Frontiers in microbiology · 2025Pooled it
- Early management of adult sepsis and septic shock: Korean clinical practice guidelines.Acute and critical care · 2024Guideline
- Sepsis Alert Systems, Mortality, and Adherence in Emergency Departments: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Utility of shaking chills as a diagnostic sign for bacteremia in adults: a systematic review and meta-analysis.BMC medicine · 2024Pooled it
- Diagnostic performance and antibiotic impact of droplet digital PCR in suspected sepsis: the PROGRESS trial.Nature communications · 2026Trial
- Failure to rescue the trial: lessons from a randomised antibiotic treatment trial in the acute care setting.Trials · 2026Trial
- Dynamic Changes in Serum Choline Acetyltransferase and Acetylcholinesterase in Septic versus Non-Septic ICU Patients: A Prospective Exploratory Study.Journal of inflammation research · 2026Trial
- Cost-effectiveness of data driven personalised antibiotic dosing in critically ill patients with sepsis or septic shock.Journal of clinical monitoring and computing · 2025Trial
- Effectiveness and Safety of an Emergency Department Code Sepsis Protocol: A Pragmatic Clinical Trial.Annals of the American Thoracic Society · 2024Trial
- Time to Antibiotics and Mortality in Immunocompromised Versus Non-immunocompromised Patients With Suspected Sepsis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Automating chart review for identification of infected patients using natural language processing.JAMIA open · 2026Article
- Rapid Antimicrobial Susceptibility Testing Using Direct Centrifugation Significantly Reduces Turnaround Time While Maintaining High Diagnostic Accuracy in Bloodstream Infections.Diagnostics (Basel, Switzerland) · 2026Article
- Planning and performing CT-guided interventions for source control in septic patients: a survey by the European Society of Emergency Radiology.Insights into imaging · 2026Article
- Analytical and Clinical Evaluation of a Fully Automated Direct-from-Whole-Blood Multiplex PCR Assay Using Large-Volume Reverse Elution for Rapid Bloodstream Infection Diagnosis.Antibiotics (Basel, Switzerland) · 2026Article
440 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
rationalePrior sepsis studies evaluating antibiotic timing have shown mixed results.
objectivesTo evaluate the association between antibiotic timing and mortality among patients with sepsis receiving antibiotics within 6 hours of emergency department registration.
methodsRetrospective study of 35,000 randomly selected inpatients with sepsis treated at 21 emergency departments between 2010 and 2013 in Northern California. The primary exposure was antibiotics given within 6 hours of emergency department registration. The primary outcome was adjusted in-hospital mortality. We used detailed physiologic data to quantify severity of illness within 1 hour of registration and logistic regression to estimate the odds of hospital mortality based on antibiotic timing and patient factors. MEASUREMENTS AND MAIN
resultsThe median time to antibiotic administration was 2.1 hours (interquartile range, 1.4-3.1 h). The adjusted odds ratio for hospital mortality based on each hour of delay in antibiotics after registration was 1.09 (95% confidence interval [CI], 1.05-1.13) for each elapsed hour between registration and antibiotic administration. The increase in absolute mortality associated with an hour's delay in antibiotic administration was 0.3% (95% CI, 0.01-0.6%; P = 0.04) for sepsis, 0.4% (95% CI, 0.1-0.8%; P = 0.02) for severe sepsis, and 1.8% (95% CI, 0.8-3.0%; P = 0.001) for shock.
conclusionsIn a large, contemporary, and multicenter sample of patients with sepsis in the emergency department, hourly delays in antibiotic administration were associated with increased odds of hospital mortality even among patients who received antibiotics within 6 hours. The odds increased within each sepsis severity strata, and the increased odds of mortality were greatest in septic shock.
Indexed as
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.