Effects of antibiotic administration delay and inadequacy upon the survival of septic shock patients

Abstract

ObjectiveTo assess how antibiotic administration delay and inadequacy influence survival in septic shock patients. DesignA prospective, observational cohort study was carried out between September 2005 and September 2010. ScopePatients admitted to the ICU of a third level hospital. PatientsA total of 342 septic shock patients. InterventionsNone. Variables of interestThe time to antibiotic administration (difference between septic shock presentation and first administered dose of antibiotic) and its adequacy (in vitro susceptibility testing of isolated pathogens) were determined. ResultsICU and hospital mortality were 26.4% and 33.5%, respectively. The median delay to administration of the first antibiotic dose was 1.7h. Deceased patients received antibiotics significantly later than survivors (1.3±14.5h vs. 5.8±18.02h; p=0.001). Percentage drug inadequacy was 12%. Those patients who received inadequate antibiotics had significantly higher mortality rates (33.8% vs. 51.2%; p=0.03). The coexistence of treatment delay and inadequacy was associated to lower survival rates. ConclusionsBoth antibiotic administration delay and inadequacy exert deleterious effects upon the survival of septic shock patients, independently of their characteristics or severity.