Delays in Antibiotic Initiation of Hospitalized Patients Reported

Delays in antimicrobial treatment for hospital-onset sepsis are more pronounced overnight, increasing patient risk, more for those with central-line infections

SANTA BARBARA , CA, UNITED STATES, December 17, 2024 /EINPresswire.com/ -- “The probability of antimicrobial initiation among patients with new hospital-onset sepsis declined at shift changes and overnight. Time to antimicrobial initiation for patients with sepsis onset overnight was four times longer than for patients with onset during the day," states Dr. Jennifer C. Ginestra, MD, Critical Care.

Dr. Greg Vigna, MD, JD, national PICC line attorney, states, “Hospital-acquired infections lead to sepsis and septic shock that is a unique clinical entity because of the increased morbidity and mortality associated with these types of infections. This study is evidence of broken hospitals not following their policies and procedures that put patients at risk.”

Dr. Vigna explains, “There are no excuses for this data. The time to first dose of antibiotics should be discussed in every quarterly Pharmacy & Therapeutics Meeting and reported to the Executive Committee and Governing Board of every hospital. Hospitals that don’t have in-house 24-hour pharmacists can have a Pyxis, which allows for automated medication dispensing systems of the commonly used intravenous antibiotics for hospital-acquired infections. This data shows preventable deaths are occurring across the country simply depending on whether symptoms and signs begin at night or during the day for a hospitalized patient.”

What did Dr. Ginestra report in “Association of Time of Day with Delays in Antimicrobial Initiation Among Ward Patients with Hospital-Onset Sepsis” published in AnnalsATS Volume 20, Number 9, September 2023?:

“Median time from hospital admission to sepsis onset was 7.3 days. The incidence of hospital-onset sepsis onset was approximately equally distributed throughout the day.

The unadjusted median time from sepsis onset to antimicrobial initiation was 4.1 hours.

The adjusted probability of antimicrobial initiation within 3 hours of sepsis onset exhibited a fivefold difference, ranging from 13.3% for sepsis onset at 6 A.M. to 72.4% for sepsis onset at 2 P.M.

Adherence to guideline-recommended care bundles of antimicrobial initiation within 1 and 3 hours of sepsis onset followed similar trends of decline throughout the night shift, suggesting the presence of an accumulating barrier to prompt clinical care. These findings persisted in analyses restricted to patients with the highest severity of illness and were consistent across several sensitivity analyses.”

Read Dr. Ginestra’s article: https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.202302-160OC

Dr. Vigna concludes, “This is particularly important for patients with central-line associated bloodstream infections. Approximately 8-17% of hospital-acquired sepsis is caused by infected central lines. Hospital-acquired sepsis is far more lethal than community-acquired sepsis. All efforts must be made to reduce the risk of hospital-acquired sepsis, including the use of PICC lines and other central lines made with hydrophilic technology that substantially reduces the risk of line-associated bloodstream infections from infected lines.”

Dr. Vigna is a California and Washington DC lawyer who focuses on serious injuries caused by defective medical devices including PICC lines, dialysis catheters, and other central lines. He represents the injured with the Ben Martin Law Group, a national pharmaceutical injury law firm in Dallas, Texas. The attorneys are product liability and medical malpractice attorneys, and they represent the most injured across the country.

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Greg Vigna, MD, JD
Vigna Law Group
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