title: Time to effective antibiotic administration in adult patients with septic shock: a descriptive analysis.
abstract: OBJECTIVE
  To determine the median time to antibiotic administration following the onset of septic shock at our institution as well as the appropriateness of empiric therapy, sources of delay in antibiotic administration and the effect of delays on survival.
  
  
  METHODS
  Retrospective health record review of 55 patients with septic shock admitted to the intensive care unit (ICU) between July 1, 2008 and December 31, 2009.
  
  
  METHODS
  Nine-bed adult medical-surgical ICU within a 300-bed community acute care hospital.
  
  
  METHODS
  Median time to antibiotic administration, appropriateness of empiric therapy, sources of delay in antibiotic administration.
  
  
  RESULTS
  The median (min,max) time to the initiation of antibiotics was determined to be 1.7 (0,31) hours. Only 34% (19/55) of patients received antibiotics within the recommended one hour. Empiric antibiotic therapy was determined to be appropriate in 91% (50/55) of patients. The median (min,max) time to administration of effective antibiotic therapy tended to be faster in the emergency room [1.1 (0,16) hours] compared to the ICU [2.3 (0,13)].
  
  
  CONCLUSIONS
  The median time to antibiotic administration at our institution following the onset of septic shock was longer than the evidence-based guideline recommendations of within one hour.
authors.affiliation: Clinical Pharmacy Specialist - Critical Care, Lions Gate Hospital, Lower Mainland Pharmacy Services - Fraser Health, Providence Health Care, Provincial Health Services Authority, Vancouver Coastal Health, Vancouver, British Columbia, Canada. Zahra.Kanji@vch.ca
authors.forename: Zahra
authors.initials: Z
authors.lastname: Kanji
authors.forename: Carla
authors.initials: C
authors.lastname: Dumaresque
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001955:British Columbia; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D012189:Retrospective Studies; D012772:Shock, Septic / Q000188:drug therapy* / Q000451:nursing; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents