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Timing of antibiotics in the management of community‐acquired sepsis: Can a randomised controlled trial of prehospital therapy provide answers?
Author(s) -
Udy Andrew A,
Smith Karen,
Bernard Stephen
Publication year - 2018
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12908
Subject(s) - medicine , observational study , intensive care medicine , antibiotics , medical prescription , sepsis , antibiotic therapy , randomized controlled trial , empirical treatment , pharmacology , microbiology and biotechnology , biology
Abstract 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. 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.