Friday August 4, 2006
Get antibiotics quickly !!

A remarkable work of review of medical records of 2,731 patients with septic shock from Dr. Anand Kumar and coll. is recently published in Critical Care Medicine 1. The main outcome measure was survival to hospital discharge.

What they found - "Administration of an antimicrobial effective for isolated or suspected pathogens within the first hour of documented hypotension * was associated with a survival rate of 80%".

* Hypotension was defined as a mean blood pressure of less than 65 mm Hg, a systolic blood pressure of less than 90 mm Hg, or a decrease in systolic pressure of 40 mm Hg from the patient's baseline.

• Each hour of delay in antimicrobial administration over the ensuing 6 hrs was associated with an average decrease in survival of 7.6%.
• In multivariate analysis, time to initiation of effective antimicrobial therapy was the single strongest predictor of outcome.

But look how good we are performing in field. Data found that only 50% of septic shock patients received effective antimicrobial therapy within 6 hrs of documented hypotension !!!



Reference: click to get abstract

Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock - Critical Care Medicine. 34(6):1589-1596, June 2006