Antimicrobials administration time in patients with suspected sepsis: faster is better for severe patients

In a recent report, Ascuntar et al. describes the impossibility to demonstrate a significant association between early antibiotic therapy administration and mortality in sepsis patients. Nevertheless, we believe that some methodological issues deserve their conclusions. First, the objective of the authors of an early antibiotic therapy may be ambitious considering practical daily emergency department limitation. Second, most of patients included in the study appear to suffer from sepsis and not from septic shock, which limits the impact of an early and aggressive management. At last, more than a single intervention such as antibiotic therapy, sepsis treatment is now considered as based on a "bundle of care."