Time-to-use of Intravenous Antibiotics in Patients with Sepsis in whom Activation of the Sepsis Fast Track Protocol was Facilitated by the National Early Warning Score

Abstract

Aim: To examine changes in door-to-antibiotic time in pre- and post-intervention groups.Materials and Methods: A quasi-experimental study was conducted in the Emergency Department involving adult patients who werediagnosed with sepsis or septic shock in a university-based hospital. The patients were distributed into one of two groups: a pre-interventionor post-intervention group. In the post-intervention group, among patients with a suspected infection and a National Early Warning Score(NEWS) of ≥5, the sepsis fast track protocol was used in the normotensive group and the sepsis with shock fast track protocol was used in thehypotensive group. Our primary outcome was the difference in the door-to-antibiotic time in the pre- and post-intervention groups.Results: Overall, 117 patients were included in the pre-intervention group and 102 patients in the post-intervention group. The mediandoor-to-antibiotic time in the pre-intervention group was 45 min [interquartile range (IQR): 30-65], and the median door-to-antibiotic timein the post-intervention group was 30 min (IQR: 20-55, p=0.009). However, there was no significant difference in the mortality rate (p=0.194).Conclusion: Using an activated system with NEWS for screening patients suspected with sepsis helped reduce the door-to-antibiotic time.