ArticleChest2019
ED Door-to-Antibiotic Time and Long-term Mortality in Sepsis.
Article in Chest, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 124 papers, 5 of them syntheses that pooled it.
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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.
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Who cites it
124 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Impact of manual sepsis screening in hospitalized adult patients: A systematic review.Journal of hospital medicine · 2026Pooled it
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Timing of antibiotic initiation in sepsis and neutropenic fever.Frontiers in medicine · 2025Pooled it
- Early management of adult sepsis and septic shock: Korean clinical practice guidelines.Acute and critical care · 2024Guideline
- The diagnostic value of interleukin 35 as a septic biomarker: A meta-analysis.Frontiers in medicine · 2022Pooled it
- Effectiveness and Safety of an Emergency Department Code Sepsis Protocol: A Pragmatic Clinical Trial.Annals of the American Thoracic Society · 2024Trial
- Trial
- 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
- A classification model for the telephonic triage of low acuity abdominal complaints in South Africa.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Presenting Symptoms and Antibiotic Timing Among Hospitalized Adults With Presumed Sepsis.JAMA network open · 2026Article
- Association of Timely Antibiotics and Fluid Resuscitation With Increased Discharge to Home After Sepsis.Chest · 2026Observational
- Survival trends in patients with difficult-to-treat, antibiotic-resistant, Gram-negative infections in the era of next-generation antibiotics in the USA: a retrospective cohort study.The Lancet. Infectious diseases · 2026Article
- ASP-COMPLEX: redefining antimicrobial stewardship to improve outcomes in high-risk patients with severe infections.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Impact of automated dispensing cabinets on medication administration efficiency in the emergency department.BMC emergency medicine · 2026Observational
- Time to Initiation of Antibiotic Therapy in Critically Ill Patients with Suspected Sepsis and Its Effect on Intensive Care Unit Mortality: Analysis Using Bayesian Approach.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Physician Variation in Early Sepsis Management.JAMA network open · 2026Article
- Optimal timing of antibiotics administration for sepsis or septic shock in the emergency department.BMC emergency medicine · 2026Article
- Clinical subphenotypes of sepsis based on mixed continuous and categorical data and differences in treatment effects: a cluster analysis of multicenter observational studies.Critical care (London, England) · 2026Observational
- Prehospital Care Duration and 30-Day Mortality Among Septic Shock.Emergency medicine international · 2026Article
- Clinical Gestalt to Predict Bacterial Infection and Mortality in Emergency Department Patients: A Prospective Observational Study.Journal of general internal medicine · 2026Observational
64 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe impact of antibiotic timing on sepsis outcomes remains controversial due to conflicting results from previous studies.
objectivesThis study investigated the association of door-to-antibiotic time with long-term mortality in ED patients with sepsis.
methodsThis retrospective cohort study included nontrauma adult ED patients with clinical sepsis admitted to four hospitals from 2013 to 2017. Only patients' first eligible encounter was included. Multivariable logistic regression was used to measure the adjusted association between door-to-antibiotic time and 1-year mortality. Secondary analyses used alternative antibiotic timing measures (antibiotic initiation within 1 or 3 h and separate comparison of antibiotic exposure at each hour up to hour 6), alternative outcomes (hospital, 30-day, and 90-day mortality), and alternative statistical methods to mitigate indication bias.
resultsAmong 10,811 eligible patients, median door-to-antibiotic time was 166 min (interquartile range, 115-230 min), and 1-year mortality was 19%. After adjustment, each additional hour from ED arrival to antibiotic initiation was associated with a 10% (95% CI, 5-14; P < .001) increased odds of 1-year mortality. The association remained linear when each 1-h interval of door-to-antibiotic time was independently compared with door-to-antibiotic time ≤ 1 h and was similar for hospital, 30-day, and 90-day mortality. Mortality at 1 year was higher when door-to-antibiotic times were > 3 h vs ≤ 3 h (adjusted OR, 1.27; 95% CI, 1.13-1.43) but not > 1 h vs ≤ 1 h (adjusted OR, 1.26; 95% CI, 0.98-1.62).
conclusionsDelays in ED antibiotic initiation time are associated with clinically important increases in long-term, risk-adjusted sepsis mortality.
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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.