ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Association Between Time to Appropriate Antimicrobial Treatment and 30-day Mortality in Patients With Bloodstream Infections: A Retrospective Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 2 of them syntheses that pooled it.
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Who cites it
97 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Rapid Diagnostic Tests and Antimicrobial Stewardship Programs for the Management of Bloodstream Infection: What Is Their Relative Contribution to Improving Clinical Outcomes? A Systematic Review and Network Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Pooled it
- Utility of shaking chills as a diagnostic sign for bacteremia in adults: a systematic review and meta-analysis.BMC medicine · 2024Pooled it
- Randomized controlled diagnostic trial to assess dRAST time to result and its utility for antimicrobial stewardship recommendation in bacteremic patients.Microbiology spectrum · 2025Trial
- Clinical impact and cost-consequence analysis of ePlex® blood culture identification panels for the rapid diagnosis of bloodstream infections: a single-center randomized controlled trial.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Trial
- Secondary hypoalbuminemia is independently associated with in-hospital mortality in children withAnnals of medicine · 2026Article
- Rapid Antimicrobial Susceptibility Testing Using Direct Centrifugation Significantly Reduces Turnaround Time While Maintaining High Diagnostic Accuracy in Bloodstream Infections.Diagnostics (Basel, Switzerland) · 2026Article
- Rapid MALDI-TOF MS antimicrobial susceptibility testing with the MBT FAST assay.Journal of clinical microbiology · 2026Article
- Article
- Non-destructive label-free automated identification of bacterial colonies at the species level directly on agar media using digital holography and convolutional neural network algorithms.Microbiology spectrum · 2026Article
- Comparative evaluation of EUCAST RAST and QuickMIC for rapid antimicrobial susceptibility testing of carbapenem-resistant organisms directly from positive blood cultures.Microbiology spectrum · 2026Article
- A Prediction Score Versus Procalcitonin and Presepsin for Predicting Bacteremia in the Emergency Department: A Single-Center Retrospective Cohort Study.Diagnostics (Basel, Switzerland) · 2026Article
- Concerns about "Evaluation of alternative blood culture systems in detecting pathogenic bacteria: a multi-site, observational prospective study" by Hu et al., 2026.The Lancet regional health. Western Pacific · 2026Article
- Fast Microbiology: A Pilot Study Comparing Culture-Independent Digital PCR and Blood Culture for Pathogen Detection in Sepsis.International journal of molecular sciences · 2026Article
- Clinical Characteristics, Empirical Antibiotic Appropriateness, and Outcomes of Gram-Positive Versus Gram-Negative Bacteremia in Emergency Department Patients with Sepsis.Medicina (Kaunas, Lithuania) · 2026Article
- Outcomes of linezolid, glycopeptides, and other regimens in ampicillin-resistant, vancomycin-susceptible and vancomycin-resistant enterococcal bacteremia in a resource-limited setting: stewardship implications.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Impact of Multiplex PCR Blood-Culture Identification Panels on Clinical Outcomes, Antimicrobial Stewardship, and Economic Impact in US Hospitals: A Systematic Review and Meta-Analysis.Open forum infectious diseases · 2026Review
- RAST+: pre-positivity application of EUCAST RAST using BACTEC FX growth detection plots - a proof-of-concept study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Rapid identification of microbial pathogens and antimicrobial resistance from bloodstream infections using long-read sequencing.Microbial genomics · 2026Article
- Association of early serial serum NLRP3 measurements with 28-day mortality in sepsis: a single-center retrospective landmark cohort study.BMC infectious diseases · 2026Article
- Structured integration of rapid antimicrobial susceptibility testing and antimicrobial resistance detection into an antimicrobial stewardship programme for bacteraemia.JAC-antimicrobial resistance · 2026Article
37 more citing papers are in PubMed but not listed here.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEffective antimicrobial treatment is key for survival in bloodstream infection (BSI), but the impact of timing of treatment remains unclear. Our aim was to assess the association between time to appropriate antimicrobial treatment and 30-day mortality in BSI patients.
methodsThis was a retrospective cohort study using electronic health record data from a large academic center in Sweden. Adult patients admitted between the years 2012 and 2019, with onset of BSI at the emergency department or general wards, were included. Pathogen-antimicrobial drug combinations were classified as appropriate or inappropriate based on reported in vitro susceptibilities. To avoid immortal time bias, the association between appropriate therapy and mortality was assessed with multivariable logistic regression analysis at pre-specified landmark times.
resultsWe included 10 628 BSI-episodes, occurring in 9192 unique patients. The overall 30-day mortality was 11.8%. No association in favor of a protective effect between appropriate therapy and mortality was found at the 1, 3 and 6 hours landmark after blood culture collection. At 12 hours, the risk of death increased with inappropriate treatment (adjusted odds ratio 1.17 [95% confidence interval {CI}, 1.01-1.37]) and continued to increase gradually at 24, 48, and 72 hours. Stratifying by high or low SOFA score generated similar odds ratios, with wider confidence intervals.
conclusionsDelays in appropriate antimicrobial treatment were associated with increased 30-day mortality after 12 hours from blood culture collection, but not at 1, 3, and 6 hours, in BSI. These results indicate a benchmark for providing rapid microbiological diagnostics of blood cultures.
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