Association of Delayed Antimicrobial Therapy with One-Year Mortality in Pediatric Sepsis

Han, M.; Fitzgerald, J. C.; Balamuth, F.; Keele, L.; Alpern, E. R.; Lavelle, J.; Chilutti, M.; Grundmeier, R. W.; Nadkarni, V. M.; Thomas, N. J.; Weiss, S. L.

Shock. 2017 Jan 24; 48(1):29-35

Abstract

OBJECTIVE: Delayed antimicrobial therapy in sepsis is associated with increased hospital mortality, but the impact of antimicrobial timing on long-term outcomes is unknown. We tested the hypothesis that hourly delays to antimicrobial therapy are associated with 1-year mortality in pediatric severe sepsis. DESIGN: Retrospective observational study. SETTING: Quaternary academic pediatric intensive care unit (PICU) from February 1, 2012 to June 30, 2013. PATIENTS: One hundred sixty patients aged 3 h (aOR 3.5, 95% CI 1.3, 9.8) compared with patients who received antimicrobials within 1 to 3 h from sepsis recognition. For the subset of patients who survived index PICU admission, antimicrobial therapy 3 h was not associated with 1-year mortality (aOR 2.2, 95% CI 0.5, 11.0). CONCLUSIONS: Hourly delays to antimicrobial therapy, up to 3 h, were not associated with 1-year mortality in pediatric severe sepsis in this study. The finding that antimicrobial therapy

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