SHM Converge Scientific Abstract ePoster Gallery-Predictors of Timely vs. Delayed Antibiotics in Patients With Suspected Sepsis Without Hypotension

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This retrospective cohort study examined predictors of timely antibiotics in 23,915 adult patients with suspected bacterial sepsis without hypotension across 67 Michigan hospitals (2020–2024). “Timely” antibiotics were defined as administration within 5 hours of hospital arrival, allowing 2 hours for sepsis recognition.<br /><br />Overall, 17,732 patients (74.1%) received timely antibiotics, but rates varied substantially by hospital. Median time to antibiotic order was 1.7 hours in the timely group versus 6.0 hours in the delayed group; median time to antibiotic delivery was 2.4 versus 7.6 hours.<br /><br />Several patient factors were associated with higher odds of timely antibiotics, including older age, admission from a healthcare facility, chronic lung disease, higher predicted mortality score, reported fever, urinary symptoms, respiratory symptoms, and abnormal vital signs such as temperature ≥100.4°F, heart rate >100, and respiratory rate ≥20. Some features were associated with lower odds of timely treatment, including gastrointestinal symptoms, moderate/severe liver disease, moderate/severe chronic kidney disease, congestive heart failure, and metastatic solid malignancy.<br /><br />The study also found that receiving timely antibiotics was associated with lower 30-day mortality.<br /><br />In conclusion, most non-hypotensive sepsis patients received antibiotics within 5 hours, but timing differed across hospitals and was influenced by presenting symptoms, comorbidities, and vital sign abnormalities. The authors suggest that improving recognition and treatment in patient groups more likely to experience delays could be an important quality-improvement target.

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Anna Conlon

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Author List Anna Conlon, Anurag N. Malani, Ashwin B. Gupta, Elizabeth McLaughlin, Elizabeth S. Munroe, Hallie Prescott, Harsh Bhanderi, Jennifer K. Horowitz, Megan Heath, Namita Jayaprakash, Nicholas Kuhl, Patricia Posa, Scott A. Flanders, Stephanie Taylor

Category Research

Concept Sepsis without hypotension

Concept Antibiotic administration

Concept Short-term Mortality

Concept Time to Antibiotics

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author Anna Conlon

Track Quality Improvement

Keywords

sepsis

timely antibiotics

retrospective cohort study

hospital variation

30-day mortality

adult patients

predictors

Michigan hospitals

antibiotic administration

quality improvement

Sepsis without hypotension

Antibiotic administration

Short-term Mortality

Time to Antibiotics