• Sun Young Lim, Sumin Baek, You Hwan Jo, Jae Hyuk Lee, Young Woo Um, Hee Eun Kim, and Dongkwan Han.
• Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
• J Emerg Med. 2024 May 1; 66 (5): e632e641e632-e641.

BackgroundThere is a lack of evidence-based guidelines for the administration methods of ceftriaxone in emergency departments (EDs), resulting in the reliance on individual institutional protocols for decision-making.ObjectiveThis study was performed to compare the effects of administering ceftriaxone via intravenous push (IVP) and intravenous piggyback (IVPB) on 28-day mortality in patients with sepsis.MethodsThis was a retrospective study of patients aged 18 years or older with sepsis or septic shock who visited an ED and were treated with ceftriaxone as an initial antibiotic between March 2010 and February 2019. Patients were divided into the IVP group and the IVPB group based on the administration method. The primary outcome was 28-day mortality, and multivariable Cox proportional hazards regression analysis was performed to evaluate the relationship between antibiotic administration methods and 28-day mortality.ResultsDuring the study period, a total of 939 patients were included in the final analysis, and the overall mortality rate was 12.2%. The antibiotic administration time was significantly lower in the IVP group than in the IVPB group, and the rates of antibiotic administration within 1 h and within 3 h were higher in the IVP group than in the IVPB group (p < 0.05). However, there was no significant difference in 28-day mortality between the two groups (hazard ratio 1.07, 95% confidence interval 0.69-1.65).ConclusionsIVP administration of ceftriaxone reduced the time of antibiotic administration compared with IVPB, but there was no difference in 28-day mortality.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

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