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  1. Home
  3. Physician Variation In Early Sepsis Management.
  1. Home
  3. Physician Variation In Early Sepsis Management.

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Physician Variation in Early Sepsis Management.

Ithan D Peltan1, Danielle Groat1, Jorie Butler2

  • 1Department of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Salt Lake City, Utah.

JAMA Network Open
|February 13, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

Physician timing for sepsis antimicrobial administration varied significantly in the emergency department (ED). Faster administration was not linked to overtreatment, and quicker physicians utilized proactive care strategies.

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Area of Science:

  • Emergency Medicine
  • Infectious Diseases
  • Health Services Research

Background:

  • Prompt antimicrobial therapy is crucial for sepsis management.
  • Accelerating antimicrobial administration may risk overtreatment.

Purpose of the Study:

  • To analyze physician variation in door-to-antimicrobial time for sepsis.
  • To determine if faster sepsis treatment is associated with overtreatment.

Main Methods:

  • Mixed-methods study combining retrospective quantitative data (2013-2017) and qualitative interviews (2022-2023).
  • Analysis of 9810 sepsis patients and 88 emergency department physicians across 4 Utah EDs.
  • Statistical modeling to assess variation and overtreatment; cognitive task analysis for physician interviews.

Main Results:

  • Significant physician variation in door-to-antimicrobial time (median 184 minutes).
  • Faster antimicrobial administration was not associated with increased overtreatment (P=.37).
  • Physicians with faster times reported proactive, parallel task execution and team coordination.

Conclusions:

  • Emergency department physicians exhibit considerable variation in sepsis antimicrobial timing.
  • Initiating antimicrobials faster does not appear to increase overtreatment risk.
  • Proactive care coordination characterizes physicians with shorter door-to-antimicrobial times.