The relationship between the timing of antibiotics
and mortality among septic shock
patients has not been examined among patients specifically with Staphylococcus aureus
Retrospective analysis of a Veterans Affairs S. aureus
One-hundred twenty-two hospitals in the Veterans Affairs Health System.
Patients with septic shock
and S. aureus
bacteremia admitted directly from the emergency department to the ICU from January 1, 2003, to October 1, 2015, were evaluated.
Time to appropriate antibiotic administration and 30-day mortality.
Measurements and Main Results:
A total of 506 patients with S. aureus
bacteremia and septic shock
were included in the analysis. Thirty-day mortality was 78.1% for the entire cohort and was similar for those participants with methicillin-resistant S. aureus
and methicillin-sensitive S. aureus
bacteremia. Our multivariate analysis revealed that, as compared with those who received appropriate antibiotics
within 1 hour after emergency department presentation, each additional hour that passed before appropriate antibiotics
were administered produced an odds ratio of 1.11 (95% CI, 1.02–1.21) of mortality within 30 days. This odds increase equates to an average adjusted mortality increase of 1.3% (95% CI, 0.4–2.2%) for every hour that passes before antibiotics
The results of this study further support the importance of prompt appropriate antibiotic administration for patients with septic shock
. Physicians should consider acting quickly to administer antibiotics
with S. aureus
coverage to any patient suspected of having septic shock