Is it time to implement door-to-needle time for “infection attacks”?

Laupland, Kevin B.; Ferrer, Ricard

doi:10.1007/s00134-017-4797-x

Cited by 6 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Variability of internal policies among different hospitals determines the immediate availability of resources 24 and general beliefs on sepsis importance.…”

Section: Evidence On the Implementation Of The Ssc Guidelines Implementation Of The Ssc Bundles In Real Lifementioning

confidence: 99%

“…[90][91][92][93] The doorto-needle time for antibiotic administration reflects global concerns about setting up a time-to-intervention period after the onset of symptoms. 24,76 Not only the first dose is important for outcomes, but also the second dose impacts mortality. 94 However, in some circumstances, implementing institutional protocols during the golden hour of sepsis may be challenging, and significant delays from first medical contact to the administration of the first dose of antimicrobials have been observed in prehospital and inhospital settings.…”

Section: Early Administration Of Broad-spectrum Antibiotics Ideally In the First Hour Of Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Evidence for the Application of Sepsis Bundles in 2021

Plata-Menchaca

Ruiz‐Rodríguez

Ferrer

2021

Semin Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

Sepsis represents a severe condition that predisposes patients to a high risk of death if its progression is not ended. As with other time-dependent conditions, the performance of determinant interventions has led to significant survival benefits and quality-of-care improvements in acute emergency care. Thus, the initial interventions in sepsis are a cornerstone for prognosis in most patients. Even though the evidence supporting the hour-1 bundle is perfectible, real-life application of thoughtful and organized sepsis care has improved survival and quality of care in settings promoting compliance to evidence-based treatments. Current evidence for implementing the Surviving Sepsis Campaign bundles for early sepsis management is moving forward to better approaches as more substantial evidence evolves.

show abstract

“…Variability of internal policies among different hospitals determines the immediate availability of resources 24 and general beliefs on sepsis importance.…”

Section: Evidence On the Implementation Of The Ssc Guidelines Implementation Of The Ssc Bundles In Real Lifementioning

confidence: 99%

Section: Early Administration Of Broad-spectrum Antibiotics Ideally In the First Hour Of Diagnosismentioning

confidence: 99%

Evidence for the Application of Sepsis Bundles in 2021

Plata-Menchaca

Ruiz‐Rodríguez

Ferrer

2021

Semin Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

show abstract

“…Despite mixed results, a substantial agreement exists among international experts regarding the establishment of earlier antimicrobial therapy in septic shock, and novel concepts have been recently introduced. The "doorto-needle" time of 60 min for antibiotic administration has been proposed, reflecting global concerns regarding establishing a time window for effective treatment after sepsis recognition (13,54). Nevertheless, achieving an effective application of institutional protocols administering antimicrobials within 1 hour from presentation remains challenging.…”

Section: Timing Of Antimicrobial Therapymentioning

confidence: 99%

An approach to antibiotic treatment in patients with sepsis

Martínez¹,

Plata-Menchaca²,

Ruiz‐Rodríguez³

et al. 2020

J Thorac Dis

Self Cite

View full text Add to dashboard Cite

Sepsis is a medical emergency and life-threatening condition due to a dysregulated host response to infection, which is time-dependent and associated with unacceptably high mortality. Thus, when treating suspicious or confirmed cases of sepsis, clinicians must initiate broad-spectrum antimicrobials within the first hour of diagnosis. Optimizing antibiotic use is essential to ensure successful outcomes and to reduce adverse antibiotic effects, as well as preventing drug resistance. All likely pathogens involved should be considered to provide an appropriate antibiotic coverage. Clinicians must investigate on the previous risk of multidrug-resistant (MDR) pathogens, and the principle of individualized dosing should replace the principle of standard dosing. The loading dose is an initial higher dose of an antibiotic for all patients, yet an individualized treatment approach for further doses should be implemented according to pharmacokinetics (PK)/pharmacodynamics (PD) and the presence of renal/liver dysfunction. Extended or continuous infusion of beta-lactams and therapeutic drug monitoring (TDM) can help to achieve therapeutic levels of antimicrobials. Reevaluation of duration and appropriateness of treatment at regular intervals are also necessary. De-escalation and shortened courses of antimicrobials must be considered for most patients, except in some justified circumstances. Leadership, teamwork, antimicrobial stewardship (AS) frameworks, guideline's recommendations on the optimal duration of treatments, de-escalation, and novel diagnostic stewardship approaches will help us to improve patients' quality of care.

show abstract