Management of emergency department (ED) patients with severe sepsis and septic shock focuses on early identification, hemodynamic resuscitation, and appropriate antibiotic administration. The 2012 Surviving Sepsis Campaign guidelines for the management of patients with severe sepsis and septic shock recommend that antibiotics be administered within the first hour of recognition of severe sepsis or septic shock. In contrast, a 2010 Cochrane Database Systematic Review concluded that there was no Level I evidence to support the use of early, pre-intensive care unit administration of antibiotics for patients with severe sepsis. The objective of this AAEM Clinical Practice Guideline is to summarize current evidence and provide guidance to emergency providers on the timing and selection of antimicrobial therapy in patients with severe sepsis and septic shock.
Does Early and Appropriate Antibiotic Administration Improve Mortality in Emergency Department Patients with Severe Sepsis or Septic Shock?