SSC international data from more than 28,000 patients with severe sepsis or septic shock emphasises early source control is paramount (closely followed by BP management). Get antibiotics in within 1 hour (2 at the very most) – the clock is ticking! Here, this was timed from the moment of triage or, on the wards, the moment the observations met criteria – differing slightly from previous work.
Possible signs in the data suggest it’s particularly those with severe sepsis but no hypotension that action was delayed. Also maybe under-recognition of liver dysfunction as organ failure.
Some concern that having a hair trigger for sepsis may keep antibiotic use high? Early de-escalation needs to remain high on the check-list for post-resuscitation management.