ArticleCritical care medicine2026
Pre-Referral Antibiotics and Mortality Among Adults With Sepsis in Southeast Asia: A Secondary Analysis of a Prospective Cohort Study.
Article in Critical care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
objectiveEarly antibiotics are considered critical for bacterial sepsis treatment, although the benefit of this early timing may differ by the presence of shock. Little evidence exists from low- or middle-income settings. In patients referred from community hospitals to a tertiary center, we tested whether pre-referral antibiotic administration is associated with 28-day survival in sepsis, and whether this association differs by the presence of shock.
designSecondary analysis of a prospective cohort study that enrolled patients from 2013 to 2017 with a primary diagnosis of infection made by an attending physician and at least three Surviving Sepsis Campaign criteria for sepsis.
settingTertiary care hospital in northeastern Thailand. PATIENTS: A total of 2593 adults with sepsis defined by primary diagnosis of infection and modified Sequential Organ Failure Assessment score greater than or equal to 2 who were referred from community hospitals.
interventionsAntibiotics administered at the referring community hospital. MEASUREMENTS AND MAIN
resultsThe median age was 59 years (interquartile range 44-72), 2233 (86.1%) were transferred the same day as initial presentation, and 1897 (73.2%) received antibiotics prior to referral. Blood cultures grew bacteria in 313 (12.1%). Twenty-eight-day mortality was 18.9%. In the propensity score-matched cohort ( n = 722 sepsis without shock, n = 244 septic shock), shock modified the association between pre-referral antibiotics and death (interaction p = 0.001). In patients with septic shock, pre-referral antibiotics were associated with lower hazard of death (hazard ratio [HR], 0.38; 95% CI, 0.19-0.75) but in patients without shock there was no association with hazard of death (HR, 1.36; 95% CI, 0.96-1.92).
conclusionsIn rural Thailand, antibiotic administration prior to referral was associated with lower hazard of death in patients with septic shock. Our findings extend to a resource-limited setting evidence supporting the benefit of early antibiotic administration in septic patients with 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.