ArticleCritical care (London, England)2022
Time-to-antibiotics and clinical outcomes in patients with sepsis and septic shock: a prospective nationwide multicenter cohort study.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07167173 (Predictive Model for Multidrug Resistance in Patients Admitted to the Emergency Department With Sepsis), which is not on this map. Cited by 106 papers, 4 of them syntheses that pooled it.
What it found
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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.
Predictive Model for Multidrug Resistance in Patients Admitted to the Emergency Department With Sepsis
Who cites it
106 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- 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
- Early detection of sepsis using machine learning algorithms: a systematic review and network meta-analysis.Frontiers in medicine · 2024Pooled it
- Mortality among adult patients with sepsis and septic shock in Korea: a systematic review and meta-analysis.Clinical and experimental emergency medicine · 2023Pooled it
- Diagnostic performance and antibiotic impact of droplet digital PCR in suspected sepsis: the PROGRESS trial.Nature communications · 2026Trial
- Trial
- From early recognition to precision medicine: advances in the diagnosis and management of adult sepsis and septic shock-a narrative review.Infection · 2026Review
- 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
- Diagnostic Uncertainty and Antibiotic Timing in Sepsis: Observational Validation of a Dual-Axis Decision Model.Critical care explorations · 2026Observational
- Prehospital Administration of Antibiotics for Patients with Suspected Severe Infection: A Systematic Review and Meta Analysis.Antibiotics (Basel, Switzerland) · 2026Review
- Septic Shock Associated With Cystostomy: A Fatal Case Due to Delayed Infection Recognition.The American journal of case reports · 2026Article
- Rapid microbiological diagnostics for sepsis in critical care: integrating technological advances with antimicrobial stewardship.Acute and critical care · 2026Article
- The Influence of Nurse Staffing and Workload on Medication Administration Errors: A Scoping Review.Journal of advanced nursing · 2026Article
- Healthcare resource utilization and readmission outcomes in patients treated with ceftolozane/tazobactam: real-world insights from the multinational SPECTRA study.JAC-antimicrobial resistance · 2026Article
- Ceftazidime-avibactam versus polymyxin B for carbapenem-resistant gram-negative bacteria-associated post-neurosurgical meningitis: a retrospective comparative study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Impact of automated dispensing cabinets on medication administration efficiency in the emergency department.BMC emergency medicine · 2026Observational
- Explainable machine learning algorithms for preoperative risk stratification of urosepsis after retrograde intrarenal surgery.Urolithiasis · 2026Article
- BRD4 modulates antimicrobial defense via non-canonical NRF2 activation in macrophages to confer protection against sepsis.PLoS pathogens · 2026Article
- Early Antibiotic Therapy in Sepsis Without Shock: A Multimethod Study of Heterogeneous Treatment Effects in ICU Patients.Infectious diseases and therapy · 2026Article
- The Role of Combination Antibiotic Therapy in Combatting Drug-ResistantAntibiotics (Basel, Switzerland) · 2026Review
46 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundTimely administration of antibiotics is one of the most important interventions in reducing mortality in sepsis. However, administering antibiotics within a strict time threshold in all patients suspected with sepsis will require huge amount of effort and resources and may increase the risk of unintentional exposure to broad-spectrum antibiotics in patients without infection with its consequences. Thus, controversy still exists on whether clinicians should target different time-to-antibiotics thresholds for patients with sepsis versus septic shock.
methodsThis study analyzed prospectively collected data from an ongoing multicenter cohort of patients with sepsis identified in the emergency department. Adjusted odds ratios (ORs) were compared for in-hospital mortality of patients who had received antibiotics within 1 h to that of those who did not. Spline regression models were used to assess the association of time-to-antibiotics as continuous variables and increasing risk of in-hospital mortality. The differences in the association between time-to-antibiotics and in-hospital mortality were assessed according to the presence of septic shock.
resultsOverall, 3035 patients were included in the analysis. Among them, 601 (19.8%) presented with septic shock, and 774 (25.5%) died. The adjusted OR for in-hospital mortality of patients whose time-to-antibiotics was within 1 h was 0.78 (95% confidence interval [CI] 0.61-0.99; p = 0.046). The adjusted OR for in-hospital mortality was 0.66 (95% CI 0.44-0.99; p = 0.049) and statistically significant in patients with septic shock, whereas it was 0.85 (95% CI 0.64-1.15; p = 0.300) in patients with sepsis but without shock. Among patients who received antibiotics within 3 h, those with septic shock showed 35% (p = 0.042) increased risk of mortality for every 1-h delay in antibiotics, but no such trend was observed in patients without shock.
conclusionTimely administration of antibiotics improved outcomes in patients with septic shock; however, the association between early antibiotic administration and outcome was not as clear in patients with sepsis without shock.
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