{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:21:34Z","timestamp":1756902094319,"version":"3.44.0"},"reference-count":18,"publisher":"The Pediatric Pharmacy Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:sec>\n          <jats:title>OBJECTIVE<\/jats:title>\n          <jats:p>The purpose of this study was to determine if administration of antibiotics within 1 hour of meeting sepsis criteria improved patient outcomes versus antibiotics administered greater than 1 hour after meeting sepsis criteria in pediatric patients. The Surviving Sepsis Campaign's international guidelines recommend appropriate antimicrobial therapy be administered within 1 hour of recognition of severe sepsis or septic shock. Data regarding outcomes in pediatric patients with sepsis regarding antibiotic timing are currently limited.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>METHODS<\/jats:title>\n          <jats:p>This was a retrospective chart review of 69 pediatric patients admitted between July 1, 2013, and June 30, 2016, with a diagnosis of sepsis.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>RESULTS<\/jats:title>\n          <jats:p>The primary outcome of in-hospital mortality was 7.1% in the within 1 hour group versus 14.6% in the greater than 1 hour group (p = 0.3399). Median hospital length of stay was significantly shorter in the within 1 hour group (15.4 versus 39.2 days, p = 0.0022). Median intensive care unit length of stay was also significantly shorter in the within 1 hour group (3.1 versus 33.6 days, p = 0.0191). There were no differences between groups for pediatric intensive care unit admission, end organ dysfunction, time to intubation, or time on the ventilator.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>CONCLUSIONS<\/jats:title>\n          <jats:p>Pediatric patients who receive antimicrobial therapy within 1 hour of meeting sepsis criteria had improved hospital and intensive care unit length of stay. This study supports the Surviving Sepsis Guidelines recommendation to administer antibiotics within 1 hour in pediatric patients with sepsis or septic shock.<\/jats:p>\n        <\/jats:sec>","DOI":"10.5863\/1551-6776-27.1.45","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T19:58:10Z","timestamp":1640203090000},"page":"45-50","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Rapid Initiation Versus Delayed Initiation of Antibiotics in Pediatric Patients With Sepsis"],"prefix":"10.5863","volume":"27","author":[{"given":"Mallory C.","family":"Cowart","sequence":"first","affiliation":[{"name":"Pharmacy Services (MCC), Arnold Palmer Hospital for Children, Orlando, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis S.","family":"Heath","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (TSH, AS), Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrakeia","family":"Shipman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (TSH, AS), Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"2","key":"i1551-6776-27-1-45-b1","series-title":"Pediatr Crit Care Med","first-page":"e52","article-title":"Surviving Sepsis Campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children","volume":"21","year":"2020","unstructured":"Weiss\n              SL,\n            \n            \n              Peters\n              MJ,\n            \n            \n              Alhazzani\n              W,\n            \n          \n          .\n\t\t\t\t\tSurviving Sepsis Campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children.\n\t\t\t\t\tPediatr Crit Care Med.\n\t\t\t\t\t2020;\n\t\t\t\t\t21(\n\t\t\t\t\t2):\n\t\t\t\t\te52\u2013\n\t\t\t\t\te106."},{"issue":"1","key":"i1551-6776-27-1-45-b2","series-title":"Pediatr Crit Care Med","first-page":"2","article-title":"International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics","volume":"6","year":"2005","unstructured":"Goldstein\n              B,\n            \n            \n              Giroir\n              B,\n            \n            \n              Randolph\n              A,\n            \n          \n          .\n\t\t\t\t\tInternational pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics.\n\t\t\t\t\tPediatr Crit Care Med.\n\t\t\t\t\t2005;\n\t\t\t\t\t6(\n\t\t\t\t\t1):\n\t\t\t\t\t2\u2013\n\t\t\t\t\t8."},{"issue":"6","key":"i1551-6776-27-1-45-b3","series-title":"Crit Care Med","first-page":"1589","article-title":"Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock","volume":"34","year":"2006","unstructured":"Kumar\n              A,\n            \n            \n              Roberts\n              D,\n            \n            \n              Wood\n              KE,\n            \n          \n          .\n\t\t\t\t\tDuration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock.\n\t\t\t\t\tCrit Care Med.\n\t\t\t\t\t2006;\n\t\t\t\t\t34(\n\t\t\t\t\t6):\n\t\t\t\t\t1589\u2013\n\t\t\t\t\t1596."},{"issue":"9","key":"i1551-6776-27-1-45-b4","series-title":"Am J Respir Crit Care Med","first-page":"861","article-title":"Effectiveness of treatments for severe sepsis: a prospective, multi-center, observational study","volume":"180","year":"2009","unstructured":"Ferrer\n              R,\n            \n            \n              Artigas\n              A,\n            \n            \n              Suarez\n              D,\n      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Med.\n\t\t\t\t\t2011;\n\t\t\t\t\t39(\n\t\t\t\t\t9):\n\t\t\t\t\t2066\u2013\n\t\t\t\t\t2071."},{"issue":"4","key":"i1551-6776-27-1-45-b6","series-title":"Crit Care Med","first-page":"1045","article-title":"Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department","volume":"38","year":"2010","unstructured":"Gaieski\n              DF,\n            \n            \n              Mikkelsen\n              ME,\n            \n            \n              Band\n              RA,\n            \n          \n          .\n\t\t\t\t\tImpact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department.\n\t\t\t\t\tCrit Care Med.\n\t\t\t\t\t2010;\n\t\t\t\t\t38(\n\t\t\t\t\t4):\n\t\t\t\t\t1045\u2013\n\t\t\t\t\t1053."},{"issue":"4","key":"i1551-6776-27-1-45-b7","series-title":"Crit Care Med","first-page":"623","article-title":"Increased time to initial antimicrobial administration is associated with progression to septic shock in severe sepsis patients","volume":"45","year":"2017","unstructured":"Whiles\n              BB,\n            \n            \n              Deis\n              AS,\n            \n            \n              Simpson\n              SQ.\n            \n          \n          Increased time to initial antimicrobial administration is associated with progression to septic shock in severe sepsis patients.\n\t\t\t\t\tCrit Care Med.\n\t\t\t\t\t2017;\n\t\t\t\t\t45(\n\t\t\t\t\t4):\n\t\t\t\t\t623\u2013\n\t\t\t\t\t629."},{"issue":"11","key":"i1551-6776-27-1-45-b8","series-title":"Crit Care Med","first-page":"2409","article-title":"Delayed antimicrobial therapy increases mortality and organ dysfunction duration in pediatric sepsis","volume":"42","year":"2014","unstructured":"Weiss\n              SL,\n            \n            \n              Fitzgerald\n        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sepsis.\n\t\t\t\t\tJAMA.\n\t\t\t\t\t2018;\n\t\t\t\t\t320(\n\t\t\t\t\t4):\n\t\t\t\t\t358\u2013\n\t\t\t\t\t367."},{"issue":"9","key":"i1551-6776-27-1-45-b10","series-title":"Pediatr Crit Care Med","first-page":"817","article-title":"Protocolized treatment is associated with decreased organ dysfunction in pediatric severe sepsis","volume":"17","year":"2016","unstructured":"Balamuth\n              F,\n            \n            \n              Weiss\n              SL,\n            \n            \n              Fitzgerald\n              JC,\n            \n          \n          .\n\t\t\t\t\tProtocolized treatment is associated with decreased organ dysfunction in pediatric severe sepsis.\n\t\t\t\t\tPediatr Crit Care Med.\n\t\t\t\t\t2016;\n\t\t\t\t\t17(\n\t\t\t\t\t9):\n\t\t\t\t\t817\u2013\n\t\t\t\t\t822."},{"issue":"1","key":"i1551-6776-27-1-45-b11","series-title":"Crit Care","first-page":"293","article-title":"Timing of antibiotics, volume, and vasoactive infusions in children with sepsis admitted to intensive care","volume":"19","year":"2015","unstructured":"van Paridon\n              BM,\n            \n            \n              Sheppard\n              C,\n            \n            \n              Garcia\n              GG,\n            \n          \n          .\n\t\t\t\t\tTiming of antibiotics, volume, and vasoactive infusions in children with sepsis admitted to intensive care.\n\t\t\t\t\tCrit Care.\n\t\t\t\t\t2015;\n\t\t\t\t\t19(\n\t\t\t\t\t1):\n\t\t\t\t\t293."},{"issue":"8","key":"i1551-6776-27-1-45-b12","series-title":"Pediatr Blood Cancer","first-page":"1299","article-title":"Prompt administration of antibiotics is associated with improved outcomes in febrile neutropenia in children with cancer","volume":"60","year":"2013","unstructured":"Fletcher\n              M,\n            \n            \n              Hodgkiss\n              H,\n            \n            \n              Zhang\n              S,\n            \n          \n          .\n\t\t\t\t\tPrompt administration of antibiotics is associated with improved outcomes in febrile neutropenia in children with cancer.\n\t\t\t\t\tPediatr Blood Cancer.\n\t\t\t\t\t2013;\n\t\t\t\t\t60(\n\t\t\t\t\t8):\n\t\t\t\t\t1299\u2013\n\t\t\t\t\t1306."},{"issue":"4","key":"i1551-6776-27-1-45-b13","series-title":"Hosp Pediatr","first-page":"311","article-title":"Antibiotic timing in pediatric septic shock","volume":"10","year":"2020","unstructured":"Lane\n              RD,\n            \n            \n              Olson\n              J,\n            \n            \n              Reeder\n              R,\n            \n          \n          .\n\t\t\t\t\tAntibiotic timing in pediatric septic shock.\n\t\t\t\t\tHosp Pediatr.\n\t\t\t\t\t2020;\n\t\t\t\t\t10(\n\t\t\t\t\t4):\n\t\t\t\t\t311\u2013\n\t\t\t\t\t317."},{"issue":"10","key":"i1551-6776-27-1-45-b14","series-title":"Pediatr Emerg Care","first-page":"464","article-title":"Timing of antibiotic administration in pediatric sepsis","volume":"36","year":"2020","unstructured":"Creedon\n              JK,\n            \n            \n              Vargas\n              S,\n            \n            \n              Asaro\n              LA,\n            \n            \n              Wypij\n              D,\n            \n            \n              Paul\n              R,\n            \n            \n              Melendez\n              E.\n            \n          \n          Timing of antibiotic administration in pediatric sepsis.\n\t\t\t\t\tPediatr Emerg Care.\n\t\t\t\t\t2020;\n\t\t\t\t\t36(\n\t\t\t\t\t10):\n\t\t\t\t\t464\u2013\n\t\t\t\t\t467."},{"key":"i1551-6776-27-1-45-b15","series-title":"J Pediatr","first-page":"183","article-title":"Delayed administration of antibiotics beyond the first hour of recognition is associated with increased mortality rates in children with sepsis\/severe sepsis and septic shock","volume":"233","year":"2021","unstructured":"Sankar\n              J,\n            \n            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International Classification of Diseases: [10th] Tenth Revision, 2nd Edition\n          ,\n\t\t\t\t\tWorld Health Organization;\n\t\t\t\t\t2004."},{"issue":"10","key":"i1551-6776-27-1-45-b18","series-title":"Ann Am Thorac Soc","first-page":"1569","article-title":"An empiric antibiotic protocol using risk stratification improves antibiotic selection and timing in critically ill children","volume":"11","year":"2014","unstructured":"Karsies\n              TJ,\n            \n            \n              Sargel\n              CL,\n            \n            \n              Marquardt\n              DJ,\n            \n          \n          .\n\t\t\t\t\tAn empiric antibiotic protocol using risk stratification improves antibiotic selection and timing in critically ill children.\n\t\t\t\t\tAnn Am Thorac Soc.\n\t\t\t\t\t2014;\n\t\t\t\t\t11(\n\t\t\t\t\t10):\n\t\t\t\t\t1569\u2013\n\t\t\t\t\t1575."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/27\/1\/article-p45.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/27\/1\/45\/2989977\/i1551-6776-27-1-45.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/27\/1\/article-p45.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/27\/1\/article-p45.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:34:49Z","timestamp":1747355689000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/27\/1\/article-p45.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":18,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-27.1.45","relation":{},"ISSN":["1551-6776"],"issn-type":[{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2022]]}}}