Abstract
The recent study by Bloos and colleagues demonstrates that early initiation of antimicrobial therapy is not associated with improved survival in sepsis. We contend that these findings should not be surprising. This study is yet another part of the growing case against early and aggressive antimicrobial therapy and highlights the important roles resuscitation and source control play in the management of the septic patient. We suggest that, whenever possible, antimicrobial therapy should we withheld until objective evidence of infection has been obtained.
Highlights
The recent study by Bloos and colleagues demonstrates that early initiation of antimicrobial therapy is not associated with improved survival in sepsis
Bloos and colleagues [1] present the results of a large, prospective, multicenter, cohort study of patients in severe sepsis or septic shock
A delay in source control greater than 6 hours was significantly associated with mortality
Summary
The recent study by Bloos and colleagues demonstrates that early initiation of antimicrobial therapy is not associated with improved survival in sepsis. Bloos and colleagues [1] present the results of a large, prospective, multicenter, cohort study of patients in severe sepsis or septic shock. They identified that, in all cases, delay of antimicrobial therapy of more than 1 hour was not independently associated with mortality. A delay in source control greater than 6 hours was significantly associated with mortality.
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