{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:02:03Z","timestamp":1794002523409,"version":"4.8.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS027170"],"award-info":[{"award-number":["R01HS027170"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Timely antibiotics are key determinants of sepsis survival and are presumed to be especially critical in immunocompromised patients. However, evidence supporting this assumption is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified all adults treated for suspected sepsis in the emergency departments of 9 US hospitals, 2015\u20132024. We identified immunocompromised patients using diagnosis codes, supplemented with clinical data to define a severely immunocompromised subgroup. We used multivariable logistic regression to assess associations between time to antibiotics (primary analysis: 1\u20133 vs 0\u20131 hour; secondary analysis: 3\u20136 vs 0\u20133 hours) and in-hospital mortality, stratified by immune status and sepsis severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 39 842 hospitalizations with suspected sepsis, 20 721 occurred in non-immunocompromised patients and 19 121 in immunocompromised (2283 severe). Overall, antibiotic administration at 1\u20133 versus 0\u20131 hour was associated with increased mortality in non-immunocompromised (OR 1.33, 95% CI 1.12\u20131.59) but not immunocompromised patients (OR 1.08, 95% CI 0.94\u20131.25). Increased risk was limited to septic shock, where delayed antibiotics were associated with higher mortality in both non-immunocompromised (OR 1.41, 95% CI 1.12\u20131.76) and immunocompromised patients (OR 1.21, 95% CI 1.002\u20131.47). In contrast, no association was observed in sepsis without shock regardless of immune status, including for antibiotic administrations at 3\u20136 versus 0\u20133 hours. Effect estimates were similar for mild\u2013moderate and severe immunocompromise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Short delays in antibiotic administration were associated with increased mortality in septic shock but not in sepsis without shock, with no evidence of greater vulnerability among immunocompromised patients. These findings suggest antibiotic urgency should be guided primarily by clinical severity rather than immune competence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag401","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T20:15:46Z","timestamp":1784146546000},"page":"447-455","source":"Crossref","is-referenced-by-count":4,"title":["Time to Antibiotics and Mortality in Immunocompromised Versus Non-immunocompromised Patients With Suspected Sepsis"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2006-1236","authenticated-orcid":false,"given":"Simran","family":"Gupta","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital , Boston, Massachusetts 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