{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T04:45:40Z","timestamp":1782535540390,"version":"3.54.5"},"reference-count":16,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"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":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Optimizing early antimicrobial therapy and incorporating clinical pharmacists into sepsis treatment strategies are essential for improving patient outcomes.\n                    <jats:bold>Objective:<\/jats:bold>\n                    To examine the appropriateness of empiric antimicrobial selection for patients presenting with community onset sepsis with confirmed bacteremia, to characterize de-escalation practices, and to evaluate pharmacy involvement throughout the sepsis care process.\n                    <jats:bold>Methods:<\/jats:bold>\n                    We conducted a retrospective review of adult patients with community-onset sepsis and confirmed bacteremia who presented to the Emergency Department (ED) between 9\/2022 and 5\/2023 at our hospital. The primary outcome was the percent of patients with ineffective empiric antimicrobials. Secondary outcomes included time to de-escalation, sepsis outcomes, sepsis guidelines adherence, and pharmacy interventions.\n                    <jats:bold>Results:<\/jats:bold>\n                    109 patients were included. Median Charlson Comorbidity Index (CCI) was 6 (IQR 3-8) and Pitt bacteremia score 0 (IQR 0-1). Median time to first antibiotic administration was 29 minutes (IQR 15-50). Ineffective empiric antimicrobials occurred in 13.7% of cases, with median time to effective antibiotics at 24\u00a0h. De-escalation occurred in 84% of cases. The median time for discontinuation was 2\u00a0days for antimicrobial coverage against MRSA and atypical organisms and 4\u00a0days for coverage against\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    . Initial therapy adhered to guidelines in 70.6% of cases, with deviation primarily due to vancomycin administration in the absence of MRSA risk factors. Antibiotic-related pharmacy recommendations were made in 40% (n = 44\/109) of ED patients and 96% (n = 105\/109) of hospitalized patients. In-hospital mortality, ICU admission, 30-day infection related re-admission and\n                    <jats:italic toggle=\"yes\">C. difficile<\/jats:italic>\n                    infection within 6 months were 8.3% (n = 9), 42.2% (n = 46), 8.3% (n = 9), and 1.8% (n = 2), respectively.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Pharmacist involvement led to appropriate antimicrobial selection in the ED, effective de-escalation, and favorable sepsis outcomes.\n                  <\/jats:p>","DOI":"10.1177\/08971900251394125","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:22:00Z","timestamp":1762474920000},"page":"322-329","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Appropriateness of Empiric Antimicrobial Therapy for Community Onset Sepsis With Bacteremia in the Emergency Department: A Multidisciplinary Approach"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7786-7608","authenticated-orcid":false,"given":"Salma","family":"Abdelwahab","sequence":"first","affiliation":[{"name":"NYU Langone Health Tisch\/Kimmel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanina","family":"Dubrovskaya","sequence":"additional","affiliation":[{"name":"NYU Langone Health Tisch\/Kimmel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6673-6091","authenticated-orcid":false,"given":"Kassandra","family":"Marsh","sequence":"additional","affiliation":[{"name":"NYU Langone Health Tisch\/Kimmel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Merchan","sequence":"additional","affiliation":[{"name":"NYU Langone Health Tisch\/Kimmel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Smalley","sequence":"additional","affiliation":[{"name":"NYU Langone Health Tisch\/Kimmel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Siegfried","sequence":"additional","affiliation":[{"name":"NYU Langone Health Tisch\/Kimmel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"NYU Langone Health Tisch\/Kimmel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.7571"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003342"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad447"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.12.045"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05653-0"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005357"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.03935-14"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw402"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-0087"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm460"},{"key":"e_1_3_6_12_2","unstructured":"Centers for Disease Control and Prevention. Hospital sepsis program core elements; 2023. https:\/\/www.cdc.gov\/sepsis\/core-elements\/resources.html. Accessed 7 September 2023."},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12093188"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.12163"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz173"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/jac5.1723"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/0897190012467211"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900251394125","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08971900251394125","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900251394125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T03:56:43Z","timestamp":1782532603000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08971900251394125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/08971900251394125"],"URL":"https:\/\/doi.org\/10.1177\/08971900251394125","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,6]]}}}