Sepsis Antibiotic Timing Shows Physician Divide
Emergency department physicians differ in how quickly they initiate antibiotics for suspected sepsis.
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By
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Kathryn Wighton
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March 2, 2026
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Clinical Scorecard: Sepsis Antibiotic Timing Shows Physician Divide
At a Glance
| Category | Detail |
|---|
| Condition | Sepsis |
| Key Mechanisms | Door-to-antimicrobial time and physician practice patterns. |
| Target Population | Adult patients (18 years or older) meeting Sepsis-3 criteria. |
| Care Setting | Emergency department (ED) in a regional health system. |
Key Highlights
- Study evaluated 9,180 adult patients treated by 88 attending ED physicians.
- Median door-to-antimicrobial time was 155 minutes, with a range of 89.5 to 218 minutes.
- Only 8.5% of patients were adjudicated as not having an infection.
- No significant association found between antimicrobial timing and overtreatment.
- Qualitative interviews revealed differences in care processes among physicians.
Guideline-Based Recommendations
Diagnosis
- Utilize Sepsis-3 criteria for diagnosis.
Management
- Initiate antimicrobial treatment as early as possible without increasing overtreatment.
Monitoring & Follow-up
- Assess door-to-antimicrobial times and adjust practices accordingly.
Risks
- Consider potential for residual confounding in practice patterns.
Patient & Prescribing Data
Adult patients with sepsis in the ED.
Faster antimicrobial administration did not correlate with increased overtreatment.
Clinical Best Practices
- Encourage proactive communication and early multidisciplinary coordination.
- Adopt parallel task execution in sepsis evaluation and treatment.
References
