Effects of antibiotic administration delay and inadequacy upon the survival of septic shock patients.

Objective: To assess how antibiotic administration delay and inadequacy influence survival in septic shock patients.

Design: A prospective, observational cohort study was carried out between September 2005 and September 2010.

Scope: Patients admitted to the ICU of a third level hospital.

Patients: A total of 342 septic shock patients

Interventions: None

Variables Of Interest: The time to antibiotic administration (difference between septic shock presentation and first administered dose of antibiotic) and its adequacy (in vitro susceptibility testing of isolated pathogens) were determined.

Results: ICU and hospital mortality were 26.4% and 33.5%, respectively. The median delay to administration of the first antibiotic dose was 1.7h. Deceased patients received antibiotics significantly later than survivors (1.3±14.5h vs. 5.8±18.02h; P=.001). Percentage drug inadequacy was 12%. Those patients who received inadequate antibiotics had significantly higher mortality rates (33.8% vs. 51.2%; P=.03). The coexistence of treatment delay and inadequacy was associated to lower survival rates.

Conclusions: Both antibiotic administration delay and inadequacy exert deleterious effects upon the survival of septic shock patients, independently of their characteristics or severity.