“An empiric antimicrobial guide specific for severe sepsis was associated with a reduced length of stay, a significantly earlier time to first dose antibiotic, and significantly lower total and variable hospital costs,” reported Hutchison et al.1
Information was abstracted from charts of 119 patients treated at a large medical center. The control group consisted of 67 patients treated before implementation of the medication guide, and the intervention group included 52 patients treated after implementation. The guide provided recommendations of first and second antibiotic choice based on the origin (e.g., health care iatrogenesis, community-acquired or a patient with neutropenia) and the location of the severe sepsis (e.g., lung, skin, gastrointestinal). Postimplementation, the time to first antibiotic administration (9.8 ± 8.8 vs. 14.7 ± 11.5 hours) and the overall length of stay (1.77 ± 1.13 vs. 14.90 ± 45.07 days) were significantly shorter. Significant cost savings were realized in the total (30%) and variable costs ($2,831) of the patient stay.
Implications. The two most important factors in successful sepsis treatment are time to treatment and antibiotic choice. Evidence-based recommendations contained on a single page were cost effective and improved care by getting the correct antibiotic to the patient more quickly.