Timing of antibiotics in the management of community-acquired

Emerg Med Australas · Apr 2018

Randomized Controlled Trial Observational Study

Timing of antibiotics in the management of community-acquired sepsis: Can a randomised controlled trial of prehospital therapy provide answers?

Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. ⋯ Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical. A trial of prehospital antibiotic administration (by paramedics) in patients with suspected sepsis would therefore provide crucial data, and go a long way to determining whether earlier empirical therapy does actually improve outcomes.

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- Andrew A Udy, Karen Smith, and Stephen Bernard.
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
- Emerg Med Australas. 2018 Apr 1; 30 (2): 270-272.
AbstractSignificant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical. A trial of prehospital antibiotic administration (by paramedics) in patients with suspected sepsis would therefore provide crucial data, and go a long way to determining whether earlier empirical therapy does actually improve outcomes.© 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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Timing of antibiotics in the management of community-acquired sepsis: Can a randomised controlled trial of prehospital therapy provide answers?

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