Delays in Administration of the Second Antibiotic Dose in Patients With Severe Sepsis and Septic Shock

Purpose: The aim of this study was to determine the incidence of significant delays in administration of the second antibiotic dose in patients treated for severe sepsis and septic shock at a single community teaching hospital as well as to assess patient outcomes associated with second dose delays. Methods: This single-center, retrospective chart review evaluated patients who received at least 2 antibiotic doses for severe sepsis or septic shock. Patients were classified as having experienced a significant second dose delay if the actual interval between the first and the second antibiotic doses was greater than or equal to 125% of the recommended dosing interval. Results: Of 197 patients, 38 (19.3%) experienced a significant second antibiotic dose delay. The rate of significant delays was 17.1% in patients treated initially in the emergency department and 30.3% in patients treated initially in another inpatient location. Conclusions: This single-center study found a 19.3% rate of significant delays in antibiotic second dose administration in patients with severe sepsis and septic shock. This study was not powered to identify differences in outcomes in patients with and without significant second dose delays. Additional large-scale studies are needed to investigate the impact of antibiotic second dose delays on outcomes in patients with sepsis.