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Supportive Care in Cancer

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01-11-2017 | Original Article

Timing to antibiotic therapy in septic oncologic patients presenting without hypotension

Authors: Kathleen Morneau, Gary B. Chisholm, Frank Tverdek, Jeffrey Bruno, Katy M. Toale

Published in: Supportive Care in Cancer | Issue 11/2017

Abstract

Purpose

Sepsis accounts for only 2% of the hospitalizations worldwide but more than 17% of total in-hospital mortality. Inappropriate antimicrobial selection and delays in appropriate therapy have been associated with reduced survival in severe sepsis and septic shock. No studies to date have exclusively targeted septic oncologic patients without hypotension.

Methods

This study was a retrospective chart review of 100 adult cancer patients presenting to the emergency department with sepsis without hypotension. We investigated the effect of time to appropriate antibiotics on in-hospital mortality and hospital length of stay. It was hypothesized that increased time to antibiotic administration would worsen patient outcomes including in-hospital mortality and length of stay.

Results

Each 1-h delay in administration of appropriate antibiotic therapy increased the odds of in-hospital mortality by 16% (adjusted OR 1.16. 95% CI 1.04–1.34, p = 0.04). Time to appropriate antibiotics had no effect on hospital length of stay.

Conclusions

Time to appropriate antibiotics and in-hospital mortality were associated in this population of adult oncologic patients with sepsis without hypotension. Clinicians in the emergency department should strive to ensure the timely administration of a complete and appropriate empiric antibiotic regimen in septic patients with active cancer even in the absence of hypotension.

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Title: Timing to antibiotic therapy in septic oncologic patients presenting without hypotension
Authors: Kathleen Morneau
Gary B. Chisholm
Frank Tverdek
Jeffrey Bruno
Katy M. Toale
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 11/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-3754-0

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