Immediate vs latent antibiotic administration for septic shock or severe sepsis in Emergency department – a systematic review

Abstract

Background: Sepsis is a time-dependent, host response to infection that is linked to an unacceptable high death rate, making it a medical emergency and potentially fatal illness. Therefore, during the first hour of sepsis diagnosis, doctors treating suspected or confirmed cases must start treating patients with broad-spectrum antibiotics. In order to examine research on the effect of early (1 to 3 hours) vs immediate (0 to 1 hours) antibiotic administration on mortality in septic shock or severe sepsis patients, we conducted this systematic review. Method: The PRISMA guidelines were followed in this review. Grey literature and databases including Web of Science, PubMed, EMBASE, and the Cochrane Library were searched. We considered studies included mortality data from consecutive adult patients with septic shock or severe sepsis who were treated with antibiotics within each time frame. All writers extracted the data. Result: Following screening, eight papers were included in the final evaluation. Seven trials were carried out in the ED, and one research was done in the ICU and ED. The ED triage in three studies, ED arrival in three studies, period of organ failure in one research, and the ED registration in one study were all considered the zero time for sepsis start. Ferrer et al. and Alan et al. carried out the two largest investigations, involving 34 and 144 hospitals, respectively. Seven studies classified mortality as occurring in the hospital during the index visit, while one research defined it as occurring within 28 days following admission. Conclusion: The study found that patients with septic shock or severe sepsis who received their first antibiotic later had higher in-hospital mortality.