The golden hour for antibiotics in sepsis, reiterated. Shoot first, ask questions later?

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.