The Relationship Between First-Dose Antibiotic Delay Intervals and In-Hospital Mortality in Patients with Sepsis

Abstract

Background: Early antimicrobial therapy is the cornerstone for the treatment of sepsis, although the time targets of antibiotic delivery are unknown.

Objectives: In this study, we quantified the time interval of first antibiotic administration in sepsis patients to investigate the association between the first-dose antibiotic delay intervals and in-hospital mortality in sepsis patients.

Methods: Patients with sepsis were collected retrospectively from January 2020 to December 2022, and we divided the first-dose antibiotic use time into two intervals: emergency department (ED) triage to antibiotic order (diagnosis delay) and antibiotic order to antibiotic infusion (administration delay). We used logistic analysis to evaluate the associations between prognosis and these intervals in the patients.

Results: The median time for diagnosis delay was 3.38 h, and for administration delay, it was 0.23 h. Both delay intervals were associated with in-hospital mortality after adjusting for confounding factors, but there was no significant difference in diagnostic delay for less than 6 hours or administration delay for less than 3 hours when compared with the no-delay reference group.

Conclusion: Both delay times for first-dose antibiotics are associated with increased in-hospital mortality, but only for longer delays. Our results do not support the use of antibiotics in sepsis patients within 1 hour when they are diagnosed.