{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T05:23:21Z","timestamp":1734153801389,"version":"3.30.2"},"reference-count":18,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T00:00:00Z","timestamp":1670284800000},"content-version":"unspecified","delay-in-days":339,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2022]]},"abstract":"Abstract<\/jats:title>\n\t \n\t Objectives:<\/jats:title>\n\t Recognition of sepsis frequently occurs in emergency departments. To evaluate the appropriateness of empiric antibiotic use in the setting of suspected sepsis in emergency department, the percentages of bacterial infection and antibiotic-related adverse drug effects were quantified in an emergency department at an academic medical center.<\/jats:p>\n\t <\/jats:sec>\n\t \n\t Methods:<\/jats:title>\n\t We retrospectively reviewed electronic medical records of adults who presented to the emergency department between January 2018 and June 2018 with suspected sepsis (defined as having \u22652 systemic inflammatory response syndrome [SIRS] criteria) and received \u22651 dose of intravenous broad-spectrum antibiotic.<\/jats:p>\n\t <\/jats:sec>\n\t \n\t Results:<\/jats:title>\n\t In total, 218 patients were included in the final analysis. Moreover, 19.3% of these patients had confirmed bacterial infections; 44.5% had suspected bacterial infections; and 35.9% did not have bacterial infection. Elevated SIRS score (ie, \u22652) and Quick Sequential Organ Failure Assessment (qSOFA) score (ie, \u22652) were not associated with the presence of bacterial infections. We identified 90-day Clostridioides difficile<\/jats:italic> infections in 7 patients and drug-resistant organism infections in 6 patients, regardless of the presence of bacterial infections.<\/jats:p>\n\t <\/jats:sec>\n\t \n\t Conclusions:<\/jats:title>\n\t A high number of patients received intravenous broad-spectrum antibiotics in the emergency department without confirmed or suspected bacterial infections that were supported by microbiologic cultures, radiographic imaging, or other symptoms of infections. Most patients who were initially admitted to the emergency department with suspected sepsis were discharged home after receiving 1 dose of intravenous antibiotic. Patients who were initially screened using SIRS score and who received broad-spectrum antibiotics in the emergency department were without confirmed or suspected bacterial infection.<\/jats:p>\n\t <\/jats:sec>","DOI":"10.1017\/ash.2022.341","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T07:18:00Z","timestamp":1670311080000},"source":"Crossref","is-referenced-by-count":2,"title":["A case\u2013control study evaluating the unnecessary use of intravenous broad-spectrum antibiotics in presumed sepsis and septic-shock patients in the emergency department"],"prefix":"10.1017","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5490-5989","authenticated-orcid":false,"given":"Esther Y.","family":"Bae","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffeny T.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marguerite L.","family":"Monogue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,12,6]]},"reference":[{"key":"S2732494X22003412_ref11","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"S2732494X22003412_ref10","unstructured":"10. CDC\/NHSN surveillance definitions for specific types of infections. Centers of Disease Control and Prevention website. https:\/\/www.cdc.gov\/nhsn\/PDFs\/pscManual\/17pscNosInfDef_current.pdf. Accessed November 15, 2022."},{"key":"S2732494X22003412_ref15","unstructured":"15. Centers for Medicare and Medicaid Services. Sepsis Bundle Project (SEP) specifications manual for national hospital inpatient quality measures discharges 10-01-15 (4Q15) through 06-30-16 (2Q16) 2012. National Health Foundation website. https:\/\/qualitynet.cms.gov\/inpatient\/specifications-manuals#tab8. Accessed June 24, 2019."},{"key":"S2732494X22003412_ref1","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1001\/jama.2016.0288","article-title":"Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Seymour","year":"2016","journal-title":"JAMA"},{"key":"S2732494X22003412_ref12","first-page":"196","article-title":"Microbiological outcomes and antibiotic overuse in emergency department patients with suspected sepsis","volume":"75","author":"Minderhoud","year":"2017","journal-title":"Neth J Med"},{"key":"S2732494X22003412_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000217961.75225.E9"},{"key":"S2732494X22003412_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2017.139"},{"key":"S2732494X22003412_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa059"},{"key":"S2732494X22003412_ref9","first-page":"124","article-title":"One-year epidemiology of fever at the emergency department","volume":"69","author":"Limper","year":"2011","journal-title":"Neth J Med"},{"key":"S2732494X22003412_ref4","doi-asserted-by":"crossref","first-page":"e1004","DOI":"10.1097\/CCM.0000000000001891","article-title":"Timing of antibiotic administration in sepsis and septic shock: the impact that a meta-analysis does not depict","volume":"44","author":"Shirakura","year":"2016","journal-title":"Crit Care Med"},{"key":"S2732494X22003412_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.1938"},{"key":"S2732494X22003412_ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-1035-1"},{"key":"S2732494X22003412_ref7","doi-asserted-by":"publisher","DOI":"10.1086\/650580"},{"key":"S2732494X22003412_ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06506-y"},{"key":"S2732494X22003412_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz021"},{"key":"S2732494X22003412_ref16","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1056\/NEJMoa1703058","article-title":"Time to treatment and mortality during mandated emergency care for sepsis","volume":"376","author":"Seymour","year":"2017","journal-title":"N Engl J Med"},{"key":"S2732494X22003412_ref13","doi-asserted-by":"publisher","DOI":"10.1592\/phco.30.1.57"},{"key":"S2732494X22003412_ref14","doi-asserted-by":"publisher","DOI":"10.1177\/026921639601000306"}],"container-title":["Antimicrobial Stewardship & Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X22003412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T07:18:08Z","timestamp":1670311088000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X22003412\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022]]}},"alternative-id":["S2732494X22003412"],"URL":"https:\/\/doi.org\/10.1017\/ash.2022.341","relation":{},"ISSN":["2732-494X"],"issn-type":[{"type":"electronic","value":"2732-494X"}],"subject":[],"published":{"date-parts":[[2022]]},"article-number":"e193"}}