Impact of 1-hour and 3-hour sepsis time bundles on patient outcomes and antimicrobial use: A before and after cohort study

• DOI: 10.1016/j.lanwpc.2021.100305
• Publication Date: 2021-11-02T03:56:10Z
• Authors: Balasubramanian V...; Luregn Schlapbach; Donna Mason; Kathryn Wilks; Robert Seaton; Paula Lister; Adam Irwin; Paul Lane; Lyndell Redpath; Kristen Gibbons; Endrias Ergetu; Michael Rice
• Keywords: Bacteremia; Surviving Sepsis Campaign

Sepsis bundles, promulgated by Surviving Campaign have not been widely adopted because of variability in sepsis identification strategies, implementation challenges, concerns about excess antimicrobial use, and limited evidence benefit.A 1-hour septic shock a 3-hour bundle were implemented using Breakthrough Series Collaborative 14 public hospitals Queensland, Australia. A before (baseline) after (post-intervention) study evaluated its impact on outcomes prescription patients with confirmed bacteremia sepsis.Between 01 July 2017 to 31 March 2020, 6976 adults presenting the Emergency Departments had blood culture taken, 1802 (732 baseline, 1070 post-intervention) met inclusion criteria. Time antibiotics 73.7% vs 85.1% (OR 1.9 [95%CI 1.1-3.6]) compliance (48.2% 63.3%, OR 1.7, 1.4 2.1]) improved post-intervention, accompanied significant reduction Intensive Care Unit (ICU) admission rates (26.5% 17.5% 0.5, 0.4 0.7]). There no differences in-hospital 30-day post discharge mortality between two phases. In post-hoc analysis post-intervention phase, pathway was associated lower (9.7% 14.9%, 0.6, 95%CI 0.8). The proportions appropriate at baseline respectively 55.4% 64.1%, 0.9 2.1]).Implementing bundles for resulted reduced need ICU without adversely influencing prescription.