{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:03:17Z","timestamp":1780095797664,"version":"3.54.0"},"reference-count":46,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Sepsis management in elderly populations presents unique challenges due to age-related physiological changes and comorbidities. Current guidelines remain conflicted regarding optimal antibiotic timing. We conducted a retrospective, multicenter study to evaluate the association between antibiotic administration timing and short-term and long-term outcomes in elderly sepsis patients.\n                    <jats:bold>Methods:<\/jats:bold>\n                    This retrospective cohort study analyzed data from the MIMIC-IV (v3.1) database. Patients were categorized into the early group (antibiotics initiated within 1\u2005h) and the late group (antibiotics initiated &gt;1\u2005h after diagnosis). Further analyses were stratified by shock status (septic shock vs non-septic shock) and pathogen type (Gram-positive vs Gram-negative bacteria). Multivariable Cox regression assessed associations between antibiotic administration timing and 28-\/180-\/365-day hospital mortality. Restricted cubic spline models evaluated dose-response relationships. The primary outcome was 28-day hospital mortality. Secondary outcomes included 180-day and 365-day mortality rates, along with the incidence of continuous renal replacement therapy (CRRT) and mechanical ventilation requirements.\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 12,425 patients met the inclusion criteria from the MIMIC-IV database. The multivariable-adjusted analysis demonstrated that delayed antibiotics administration was significantly associated with a 35% increased risk of 28-day all-cause hospital mortality (HR\u2009=\u20091.35, 95% CI 1.22-1.52;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.001), a 43% elevated 180-day hospital mortality risk (HR\u2009=\u20091.43, 95% CI 1.30-1.56;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u20090.001), and a 45% higher 365-day mortality risk (HR\u2009=\u20091.45, 95% CI 1.33-1.56; P\u2009&lt;\u20090.001). Stratified analyses revealed mortality benefits persisted in non-shock patients (28-day HR\u2009=\u20091.31, P\u2009&lt;\u20090.001) and Gram-positive infections (28-day HR\u2009=\u20091.63, P\u2009&lt;\u20090.001), whereas no significant associations emerged in septic shock (28-day HR\u2009=\u20090.82, 95%CI 0.65-1.03; P\u2009=\u20090.081) or Gram-negative infections (HR\u2009=\u20091.04, 95%CI 0.87-1.24; P\u2009=\u20090.692). A linear relationship was observed between antibiotic delay and mortality (Nonlinear\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.88).\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Early antibiotic administration improves survival in elderly sepsis patients, particularly non-shock cases and Gram-positive infections. These insights advocate the importance of individualized selection based on patients\u2019 clinical context in critical care practice.\n                  <\/jats:p>","DOI":"10.1177\/08850666251387633","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T18:18:18Z","timestamp":1761157098000},"page":"609-619","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The Relationship Between Antibiotic Administration Timing and Short-Term and Long-Term Prognosis in Elderly Septic Patients"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2625-1733","authenticated-orcid":false,"given":"Yuhui","family":"Pan","sequence":"first","affiliation":[{"name":"Beijing Friendship Hospital, Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Ma","sequence":"additional","affiliation":[{"name":"Beijing Friendship Hospital, Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Wan","sequence":"additional","affiliation":[{"name":"Beijing Friendship Hospital, Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoxing","family":"Wang","sequence":"additional","affiliation":[{"name":"Beijing Friendship Hospital, Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaorong","family":"Xie","sequence":"additional","affiliation":[{"name":"Beijing Friendship Hospital, Capital Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-0352"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40779-023-00462-y"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2020.12.015"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000004224"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1703058"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.0183"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30469-1"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2644-x"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2024.06.015"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005357"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-025-00776-0"},{"key":"e_1_3_3_13_2","article-title":"Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all cause mortality: Population based cohort study","volume":"364","author":"Gharbi M","year":"2019","unstructured":"Gharbi M, Drysdale JH, Lishman H, et al. 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