{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T02:44:21Z","timestamp":1769309061515,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T00:00:00Z","timestamp":1670803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the association between the timing and adequacy of antibiotics administered to patients presenting with culture\u2010positive sepsis and septic shock to the ED and in\u2010hospital mortality and\/or intensive care unit (ICU) admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multicentre retrospective cohort study of ED presentations at four metropolitan hospitals in Sydney, Australia between January 2017 and November 2019. Encounters for patients aged \u226516\u2009years meeting specified criteria for sepsis or septic shock with antibiotic administration within the first 6\u2009h of presentation were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 7611 encounters included in the study, 2328 (31%) were culture positive, and 2228 (29%) met the criteria for septic shock. In culture\u2010positive sepsis encounters, partial or inadequate antibiotic coverage was associated with higher risk of death or ICU admission (adjusted odds ratio [AOR] 1.50, 95% confidence interval [CI] 1.04\u20132.06 and 1.95, 95% CI 1.28\u20132.99, respectively). This effect was not significant in septic shock encounters (AOR 1.10, 95% CI 0.64\u20131.88) with partial coverage and (AOR 1.63, 95% CI 0.81\u20133.3) inadequate coverage. Time to antibiotics was not significantly associated with the risk of mortality\/ICU admission. This inference remained the same when analysis was restricted to cases with adequate antibiotic coverage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a large multicentre sample of patients with culture\u2010positive sepsis, inadequacy of antibiotics was associated with higher risk of in\u2010hospital mortality or ICU admission.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14143","type":"journal-article","created":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T02:04:22Z","timestamp":1670897062000},"page":"325-332","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Association between timing and adequacy of antibiotics and adverse outcomes in patients with sepsis and septic shock: A multicentre retrospective cohort study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7349-1128","authenticated-orcid":false,"given":"Amith","family":"Shetty","sequence":"first","affiliation":[{"name":"New South Wales Ministry of Health  Sydney New South Wales Australia"},{"name":"Macquarie University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jannah","family":"Baker","sequence":"additional","affiliation":[{"name":"Macquarie University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3707-2799","authenticated-orcid":false,"given":"Gladis","family":"Kabil","sequence":"additional","affiliation":[{"name":"Western Sydney University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9759-0013","authenticated-orcid":false,"given":"Aldo","family":"Saavedra","sequence":"additional","affiliation":[{"name":"The University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7021-9380","authenticated-orcid":false,"given":"Carl JE","family":"Suster","sequence":"additional","affiliation":[{"name":"The University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Moscova","sequence":"additional","affiliation":[{"name":"The University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Iredell","sequence":"additional","affiliation":[{"name":"The University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1642-142X","authenticated-orcid":false,"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Macquarie University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1707170"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.2.2007102"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06506-y"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000217961.75225.E9"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201609-1848OC"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001142"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2431-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc7751"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1086\/379825"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000050298.59549.4A"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1086\/677637"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12894"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0288"},{"key":"e_1_2_8_16_1","volume-title":"Sepsis Kills: Adult Antibiotic \u2013 WSLHD WSYD\u2010GL202559","author":"Western Sydney Local Health District Drug Committee","year":"2012"},{"key":"e_1_2_8_17_1","unstructured":"Clinical Excellence Commission.Adult inpatient sepsis pathway.2014. 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