Timing of antibiotics in the management of community-acquired sepsis

Can a randomised controlled trial of prehospital therapy provide answers?

Research output: Contribution to journalArticleOtherpeer-review

1 Citation (Scopus)

Abstract

Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical. A trial of prehospital antibiotic administration (by paramedics) in patients with suspected sepsis would therefore provide crucial data, and go a long way to determining whether earlier empirical therapy does actually improve outcomes.

Original languageEnglish
Pages (from-to)270-272
Number of pages3
JournalEMA - Emergency Medicine Australasia
Volume30
Issue number2
DOIs
Publication statusPublished - Apr 2018

Keywords

  • Antibiotics
  • Emergency medicine
  • Prehospital care
  • Sepsis

Cite this

@article{7fbe6ab7f5514a77a9074c2215025785,
title = "Timing of antibiotics in the management of community-acquired sepsis: Can a randomised controlled trial of prehospital therapy provide answers?",
abstract = "Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical. A trial of prehospital antibiotic administration (by paramedics) in patients with suspected sepsis would therefore provide crucial data, and go a long way to determining whether earlier empirical therapy does actually improve outcomes.",
keywords = "Antibiotics, Emergency medicine, Prehospital care, Sepsis",
author = "Udy, {Andrew A.} and Karen Smith and Stephen Bernard",
year = "2018",
month = "4",
doi = "10.1111/1742-6723.12908",
language = "English",
volume = "30",
pages = "270--272",
journal = "EMA - Emergency Medicine Australasia",
issn = "1742-6731",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Timing of antibiotics in the management of community-acquired sepsis

T2 - Can a randomised controlled trial of prehospital therapy provide answers?

AU - Udy, Andrew A.

AU - Smith, Karen

AU - Bernard, Stephen

PY - 2018/4

Y1 - 2018/4

N2 - Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical. A trial of prehospital antibiotic administration (by paramedics) in patients with suspected sepsis would therefore provide crucial data, and go a long way to determining whether earlier empirical therapy does actually improve outcomes.

AB - Significant tension surrounds the application of antibiotics in suspected infection. Guidelines stress the importance of early empirical broad-spectrum therapy, with select observational data suggesting inferior outcomes when this is delayed. In contrast, microbiological resistance is an ever increasing global problem, with many advocating for a more restricted, culture-driven approach to antibiotic prescription. Controlled trial data are urgently needed, although many clinicians would find withholding of antibiotic therapy unethical. A trial of prehospital antibiotic administration (by paramedics) in patients with suspected sepsis would therefore provide crucial data, and go a long way to determining whether earlier empirical therapy does actually improve outcomes.

KW - Antibiotics

KW - Emergency medicine

KW - Prehospital care

KW - Sepsis

UR - http://www.scopus.com/inward/record.url?scp=85034023911&partnerID=8YFLogxK

U2 - 10.1111/1742-6723.12908

DO - 10.1111/1742-6723.12908

M3 - Article

VL - 30

SP - 270

EP - 272

JO - EMA - Emergency Medicine Australasia

JF - EMA - Emergency Medicine Australasia

SN - 1742-6731

IS - 2

ER -