Timing of Antibiotics for Acute, Severe Infections - 08/08/11

Doi : 10.1016/j.emc.2008.01.004

Jesse M. Pines, MD, MBA, MSCE ^a,^b,^c,^⁎
^a Department of Emergency Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Ground Ravdin, Philadelphia, PA 19104, USA
^b Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 423 Guardian Drive, Philadelphia, PA 19104, USA
^c Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104, USA

Department of Emergency Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Ground Ravdin, Philadelphia, PA 19104.

Abstract

The importance of antibiotic timing is a common clinical question encountered in emergency medicine practice for patients who have severe infections. Various studies in the medical literature have reported associations between early antibiotic timing and improved survival for meningitis, pneumonia, and septic shock. Understanding the evidence behind antibiotic timing and survival is vital to emergency physicians, because they must balance the potential benefits of early antibiotic administration and the potential for antibiotic overuse and misuse. The measurement of antibiotic timing in pneumonia has been shown to be associated with antibiotic misuse in emergency departments. Quality organizations should study carefully the intended and unintended consequences of measuring and reporting antibiotic timing to make policy decisions on current and future performance measures in this area.

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