Assessment of Early Antibiotic Administration for Patients With Sepsis in the Emergency Department: A Retrospective Observational Study at a Tertiary Care Hospital

Background Sepsis is a severe medical illness brought on by the body’s exaggerated response to an infection. It develops when the body’s reaction to the infection results in extensive inflammation, which may lead to the potential risk of organ failure or damage. Sepsis is an acute health crisis that requires immediate treatment, inevitably in a hospital with antibiotics and supportive care. Early administration of broad-spectrum antibiotics is a cornerstone of sepsis management and is strongly recommended by the guidelines. Delays in antibiotic initiation are associated with worse clinical outcomes and increased mortality. Objective To evaluate the timing of antibiotic administration among patients presenting with septic shock and sepsis without septic shock in the emergency department and to assess its association with in-hospital mortality in relation to guideline recommendations. Materials and methods This retrospective observational study was conducted among 95 patients diagnosed with septic shock and sepsis without septic shock in the emergency department of a tertiary care hospital between February 2024 and July 2024. Data, including demographics, clinical parameters, laboratory findings, and time to antibiotic administration, were obtained from electronic medical records. Continuous variables were summarized as median (interquartile range or IQR), and categorical variables were analyzed using Pearson's chi-square test. A p-value <0.05 was considered statistically significant. Result Of the 95 patients included in the study, 65 (68.4%) had sepsis without septic shock and 30 (31.6%) had progressed to septic shock. Among the patients with septic shock treated for antibiotics, 67% received them within 60 minutes, 50% between 60-120 minutes, and 78.3% after 120 minutes. This association was statistically significant (χ²= 11.26, p=0.04). Subgroup analysis demonstrated a similar increasing trend in mortality with delayed treatment in patients with septic shock and sepsis without septic shock. Conclusion Delayed antibiotic administration was significantly associated with increased mortality in patients with septic shock and sepsis without septic shock. Although earlier treatment was more commonly observed in patients with septic shock, delays beyond the recommended timeframes were frequent. These findings highlight the importance of early recognition and prompt antibiotic initiation in emergency settings to improve patient outcomes.