Pharmacist impact on time to antibiotic administration in patients with sepsis in an ED.

Purpose: The purpose was to determine if the physical presence of a clinical pharmacist in the emergency department (ED) would decrease antibiotic order to administration time in adult patients with sepsis, severe sepsis, or septic shock.

Methods: We conducted a retrospective review of adult patients presenting to the ED between January and December 2014 with a diagnosis of sepsis, severe sepsis, or septic shock who required intravenous antibiotics.

Results: A total of 186 patients (92 patients when an ED pharmacist was present and 94 when no ED pharmacist was present) were included in the analysis. Baseline characteristics were similar between groups. When a pharmacist was present, patients received antibiotics sooner (median 0.61 vs 0.88 hour, P=.001), Surviving Sepsis Campaign goals for antibiotic administration time were more likely to be met (88% vs 72%, P=.0097), and initial antibiotics were appropriate more often (97% vs 81%, P=.0008). No significant differences were noted in intensive care unit length of stay, hospital length of stay, ventilator days, or in-hospital mortality.

Conclusions: Physical presence of a clinical pharmacist in the ED decreased time to administration and increased appropriateness of intravenous antibiotics for adult patients with sepsis, severe sepsis, or septic shock.