- Clinical Pharmacy Specialist – Critical Care, Lions Gate Hospital, Lower Mainland Pharmacy Services – Fraser Health, Providence Health Care, Provincial Health Services Authority, Vancouver Coastal Health, Vancouver, British Columbia, Canada
- Clinical Associate Professor, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
- Pharmacy Resident, Lower Mainland Pharmacy Services – Fraser Health, Providence Health Care, Provincial Health Services Authority, Vancouver Coastal Health, Vancouver, British Columbia, Canada
Summary
Objective: To determine the median time to antibiotic administration following the
onset of septic shock at our institution as well as the appropriateness of
empiric therapy, sources of delay in antibiotic administration and the effect
of delays on survival.
Research methodology: Retrospective health record review of 55 patients with septic shock
admitted to the intensive care unit (ICU) between July 1, 2008 and December 31,
2009.
Setting: Nine-bed adult medical-surgical ICU within a 300-bed community acute
care hospital.
Main outcome measures: Median time to antibiotic administration, appropriateness of empiric
therapy, sources of delay in antibiotic administration.
Results: The median (min,max) time to the initiation of antibiotics was
determined to be 1.7 (0,31) hours. Only 34% (19/55) of patients received
antibiotics within the recommended one hour. Empiric antibiotic therapy was
determined to be appropriate in 91% (50/55) of patients. The median (min,max)
time to administration of effective antibiotic therapy tended to be faster in
the emergency room [1.1 (0,16) hours] compared to the ICU [2.3 (0,13)].
Conclusion: The median time to antibiotic administration at our institution
following the onset of septic shock was longer than the evidence-based
guideline recommendations of within one hour.
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