Predictor of Early Administration of Antibiotics and a Volume Resuscitation for Young Infants with Septic Shock

Area of Science:

• Pediatric Emergency Medicine
• Infectious Diseases
• Neonatology

Background:

• Prompt administration of antibiotics and fluid bolus within 1 hour of sepsis recognition is critical for pediatric patients.
• Sepsis management in infants requires adherence to a strict 1-hour bundle protocol.
• Identifying predictors for successful sepsis bundle completion is essential for improving outcomes.

Purpose of the Study:

• To identify predictors of successful 1-hour sepsis bundle completion in infants with suspected sepsis.
• To analyze factors influencing the timely administration of critical sepsis interventions.
• To enhance the understanding of sepsis recognition in young febrile infants.

Main Methods:

• Observational study utilizing a prospective registry of febrile infants (< 90 days old) presenting to a pediatric emergency department.
• Inclusion criteria: core body temperature ≥ 38.0 °C or ≤ 36.0 °C.
• Univariate and logistic regression analyses were performed to determine predictors of 1-hour sepsis bundle completion.

Main Results:

• A total of 323 infants were registered; 118 with suspected sepsis were analyzed.
• 38 patients (32.2%) received bundle-compliant treatment.
• Logistic regression identified heart rate (odds ratio: 1.02; 95% confidence interval: 1.00-1.04) as a significant predictor of 1-hour sepsis bundle completion.

Conclusions:

• Tachycardia facilitates sepsis recognition and promotes successful completion of the 1-hour sepsis bundle in young infants with suspected septic shock.
• Heart rate is a significant predictor for timely sepsis care in infants.
• Findings suggest tachycardia may serve as an indicator for improving team-based sepsis management quality.