To examine physician-level variation in door-to-antimicrobial time and its association with overtreatment (defined as unnecessary treatment) in sepsis patients.
Approach:
Key Findings:
Median door-to-antimicrobial time was 155 minutes, with a range of 89.5 to 218 minutes.
5.1% of the total variation in timing was attributable to the physician.
No significant association between increased door-to-antimicrobial time and overtreatment (unnecessary treatment).
Qualitative differences in care processes were noted between faster and slower physicians.
Interpretation:
The findings suggest that earlier antimicrobial administration may be safe and not linked to increased overtreatment, which could influence clinical practice.
Limitations:
Data from 2013 to 2017 may not reflect current practices.
Potential residual confounding or nonlinear associations.
Study conducted within one regional health system, limiting generalizability to other settings.
Conclusion:
Physician practice patterns characterized by earlier antimicrobial administration were not associated with increased antimicrobial overtreatment.
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