Improving door-to-antibiotic time in severely septic emergency department patients

Eveline A. Hitti, John J. Lewin, Jose Lopez, Jonathan Hansen, Michael Pipkin, Taha Itani, Paul Gurny

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The Surviving Sepsis Campaign (SSC) guidelines recommend that broad-spectrum antibiotics be administered to severely septic patients within 3 h of emergency department (ED) admission. Despite the well-established evidence regarding the benefit of timely antibiotics, adoption of the SSC recommendation into daily clinical practice has been slow and sporadic. Study Objective: To study the impact of storing broad-spectrum antibiotics in an ED automated dispensing cabinet (ADC) on the timeliness of antibiotic administration in severely septic patients presenting to the ED. Methods: Retrospective observational study of timeliness of antibiotic administration in severely septic patients presenting to a community ED before and after adding broad-spectrum antibiotics to the ED ADC. Data on 56 patients before and 54 patients after the intervention were analyzed. The primary outcome measure was mean order-to-antibiotic time. Secondary outcome measures included mean door-to-antibiotic time and percentage of patients receiving antibiotics within 3 h. Results: The final analysis was on 110 patients. Order-to-antibiotic administration time was reduced by 29 min post-intervention (55 min vs. 26 min, 95% confidence interval [CI] 12.5-45.19). Mean door-to-antibiotic time was also reduced by 70 min (167 min vs. 97 min, 95% CI 37.53-102.29). The percentage of severely septic patients receiving antibiotics within 3 h of arrival to the ED increased from 65% pre-intervention to 93% post-intervention (95% CI 0.12-0.42). Conclusion: Storing key antibiotics in an institution's severe sepsis antibiogram in the ED ADC can significantly reduce order-to-antibiotic times and increase the percentage of patients receiving antibiotics within the recommended 3 h of ED arrival.

Original languageEnglish (US)
Pages (from-to)462-469
Number of pages8
JournalJournal of Emergency Medicine
Volume42
Issue number4
DOIs
StatePublished - Apr 2012
Externally publishedYes

Keywords

  • antibiotics
  • automated dispensing cabinet
  • emergency department
  • sepsis
  • timing

ASJC Scopus subject areas

  • Emergency Medicine

Fingerprint Dive into the research topics of 'Improving door-to-antibiotic time in severely septic emergency department patients'. Together they form a unique fingerprint.

Cite this