• Matthaios Papadimitriou-Olivgeris, Konstantinos Perdikis, Michela Cois, Léa Roth, Sofia Mykoniati, Charly Nusbaumer, Luce Bertaiola Monnerat, and Hervé Duplain.
• Department of Internal Medicine, Hospital of Jura, Delémont, Switzerland.
• Eur. J. Clin. Invest. 2020 Nov 1; 50 (11): e13324.

BackgroundBloodstream infections (BSIs) have been associated with high mortality. The aim of the study was to identify predictors of early (within 3 hours from triage) administration of first antibiotic dose among patients evaluated in the Emergency Department (ED) with BSI and their role in mortality.Materials And MethodsAll adult patients with BSI at the ED of the Hospital of Jura, Switzerland during a 3 year period (July 2014 to June 2017) were included.ResultsAmong 364 BSI, the most common sites of infection were urinary tract (39.6% of BSIs), lower respiratory tract (15.4%), intra-abdominal (15.4%) and primary BSI (9.1%). One-hundred-seventy-eight patients (48.9%) received the first antibiotic dose within 3 hours from triage. Multivariate analysis identified evaluation by internal medicine intern, triage scales 1 and 2, as predictors of early antibiotic administration, while, primary BSI was associated with delayed antibiotic administration. Thirty-day mortality was 12.9% (47 patients). Charlson comorbidity index, septic shock, low respiratory tract infection were independently associated with mortality, while antibiotic administration within 3 hours from triage and source control within 48 hours from triage were associated with survival.ConclusionsThe majority of patients received the first antibiotic dose after 3 hours Patients evaluated by surgical interns had a significant delay in administration of antibiotics as compared to those treated by medical interns.© 2020 Stichting European Society for Clinical Investigation Journal Foundation.

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