Sepsis has been recognized by the United Nations World Health Assembly as a global threat to the health of children and adults. The World Health Organization has established as a priority the identification of strategies for prevention, early diagnosis, and treatment of sepsis. 1 The increasing incidence of sepsis represents a major contributor to childhood morbidity. A cohort study involving US children's hospitals demonstrated that the prevalence of sepsis among children (ages 18 years and younger) had increased from 3.7% in 2004 to 4.4% in 2012, and suggested that mortality and resource utilization have decreased over the same study period. 2 The 2012 Surviving Sepsis Campaign provided guidelines for the management of childhood sepsis through a comprehensive systematic review process. 3 Many of the recommendations for management of childhood sepsis were based on low-quality evidence and expert consensus and used evidence from the care of adult sepsis. 4 While the latest version of sepsis guidelines did not include a specific description of the management of children, 5 there has been increasing interest in the extension of early goal-directed care to the use of bundled care strategies for the management of sepsis in both adults and children. [6][7][8] In this issue of JAMA, Evans and colleagues 9 report findings from a cohort study that evaluated the association between implementation of a 2013 New York State mandated sepsis bundle and mortality among children with presumed sepsis. This study involving children follows a previous report of the reduction in risk-adjusted mortality in adults associated with using bundled care protocols. 8 The specific pediatric bundled treatment approach included obtaining blood cultures, providing broadspectrum antibiotics, and instituting a 20-mL/kg intravenous fluid bolus. The study, which was conducted in emergency departments and inpatient and intensive care units across New York State, examined the risk-adjusted association between completing the 1-hour pediatric sepsis bundle and in-hospital mortality. The association with in-hospital mortality of each individual element of the sepsis bundle was also assessed. The cohort included 1179 patients aged 18 years and younger with sepsis and septic shock from 54 hospitals, which reported data to the New York State Department of Health and had a sepsis protocol initiated.In this cohort, completion of a sepsis bundle within 1 hour occurred in 294 children (24.9%) and was associated with lower risk-adjusted odds of in-hospital mortality (odds ratio, 0.59 [95% CI, 0.38-0.93]; P = .02; mortality of 8.7% among children who received bundled care within 1 hour vs 12.7% among those who did not; predicted risk difference, 4.0% [95% CI,