Cohort studyindependent cross-checkabstract only checked I-ABX-08 standard review

Antibiotic timing in septic shock

Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock.

Overview

Kumar A et al.. Crit Care Med 2006 · PMID 16625125 · DOI 10.1097/01.CCM.0000217961.75225.E9

Each hour of delay reduced survival by about 7.6% on average.

Does the study support the specific claim? No · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: Assess delay.
How was the study done?: Cohort.
How many people, animals or samples were studied?: 2154 patients.
What was actually found?: Delay worsens survival.
How large was the observed effect?: -7.6% per hour.
What do the results mean in everyday life?: Antibiotics are life-saving here.
What are the study's limitations?: Retrospective.
What does it say about Elawady's specific claim?: Contradicts claim.
Do the results apply to Germany and Europe?: High.

Does delay in effective antimicrobials after hypotension affect survival in septic shock?

Results: aOR 1.119 per hour delay (1.103-1.136); survival 79.9% if within first hour; average 7.6% decrease in survival per hour over 6 hours.
Absolute risks: Survival 79.9% with therapy in first hour.
Authors' conclusion: Time to effective antimicrobial therapy was the strongest predictor of outcome.

Contradicts C-ABX-12.

High.

Classic evidence.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	high
Directness	direct
Reproducibility	replicated
Consistency with the overall evidence	consistent
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable