Photo Credit: SeventyFour

The following is a summary of “Association of second antibiotic dose delays on mortality in patients with septic shock,” published in the December 2024 issue of Critical Care by Jabir et al. 

Researchers conducted a retrospective study to specify the delay in administering the 2nd dose of antibiotics was associated with an increased risk of mortality in patients admitted with septic shock.  

They evaluated 4 institutions in western Pennsylvania. A total of 905 patients with septic shock were included, excluding those who did not receive a 2nd dose of antibiotics, were transferred from an outside facility, or had an expected death within 6 hours of admission. The frequency of delays in administering the 2nd dose of antibiotics was analyzed, with a delay defined as greater than or equal to 25% of the antibiotic dosing interval.  

The results showed 181 (20%) patients experienced a delay in the 2nd dose of antibiotics. These patients had a higher mortality rate (35%) compared to those without a delay (26%) (P = 0.018). No significant difference was found in the median 28-day vasopressor-free days between groups (median = 26.0, IQR = 2.0), but statistical significance was achieved in the distribution of these days (Mann-Whitney U = 57,294.5, z = −2.690, P = 0.006). There was no difference in 28-day ventilator-free days. Patients with delayed 2nd dose antibiotics had a longer in-hospital length of stay (9 days vs 7 days; P = 0.022) and a more extended ICU stay (5 days vs 3 days; P = 0.007).  

Investigators concluded the delays in 2nd antibiotic dose administration were observed in patients with septic shock; these delays were shorter compared to previous studies yet still associated with increased mortality, prolonged ICU stays, and extended hospital lengths of stay.  

Source: sciencedirect.com/science/article/pii/S0883944124003538