Effect of delayed antibiotic use on mortality outcomes in patients with sepsis or septic shock: A systematic review and meta-analysis
Abstract
Background The use of antibiotics is essential in the treatment of sepsis and septic shock, and delaying their administration may impact patient mortality outcomes. However, there is currently a controversial debate surrounding this issue. In this meta-analysis, we aimed to explore the association between delayed antibiotic use and mortality in patients with sepsis and septic shock. Methods A systematic search was conducted on PubMed, EMBASE, Web of Science, and Cochrane Library to identify relevant studies published from 2013 to 2023. These studies focused on patients with sepsis or septic shock and provided information on various antibiotic administration times and mortality rates. Two independent reviewers screened and extracted the data. The quality of each study was assessed using the Newcastle-Ottawa Scale, and the collected data were analyzed using STATA 15.1 software. Results A total of 29 studies were included, consisting of 17 prospective cohort studies and 12 retrospective cohort studies. The meta-analysis showed that compared to administration of antibiotics within 1 h, each hour of delay in antibiotic administration increased the in-hospital mortality (IHM) (OR = 1.041, 95 % CI: 1.021-1.062), and ministration of antibiotics after 1 h increased the IHM (OR = 1.205, 95 % CI: 1.123-1.293). There was no significant change in the 28-day mortality (OR = 1.297, 95 % CI: 0.882-1.906), 90-day mortality (OR = 1.172, 95 % CI: 0.846-1.622), and 1-year mortality (OR = 0.986,…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Diagnostic delays in BSIs exacerbate the risk of multiorgan failure.
“These diagnostic delays not only exacerbate the risk of multiorgan failure but also contribute to longer hospital stays and higher healthcare burdens [8, 9].”
From Early prediction of bloodstream infections in ICU patients using machine learning methods based on routine laboratory parameters (2025) · cites this paper as [8]
Diagnostic delays in BSIs contribute to longer hospital stays and higher healthcare burdens.
“These diagnostic delays not only exacerbate the risk of multiorgan failure but also contribute to longer hospital stays and higher healthcare burdens [8, 9].”
From Early prediction of bloodstream infections in ICU patients using machine learning methods based on routine laboratory parameters (2025) · cites this paper as [8]
Cites
Kumar, A., Roberts, D., Wood, K. E., Light, B., Parrillo, J. E., Sharma, S., Suppes, R., Feinstein, D., Zanotti, S., Taiberg, L., et al. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000217961.75225.e9 · Cited by 6,109 · see citing works
Bloos, F., Thomas-Rüddel, D., Rüddel, H., Engel, C., Schwarzkopf, D., Marshall, J. C., Harbarth, S., Simon, P., Riessen, R., Keh, D., et al. (2014) · Critical Care · doi:10.1186/cc13755 · Cited by 240 · see citing works
Ryoo, S. M., Kim, W. Y., Sohn, C. H., Seo, D. W., Oh, B. J., Lim, K. S., & Koh, J. W. (2015) · The American Journal of the Medical Sciences · doi:10.1097/maj.0000000000000423 · Cited by 62 · see citing works
Rothrock, S. G., Cassidy, D. D., Barneck, M., Schinkel, M., Guetschow, B., Myburgh, C., Nguyen, L., Earwood, R., Nanayakkara, P. W. B., Nannan Panday, R. S., et al. (2020) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2020.04.042 · Cited by 57 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Chen, Y., Chen, Z., Xu, D., Li, S., Chen, F., Yu, X., Cai, S., Zeng, C., Ye, X., Yang, J., et al. (2025) · BMC Infectious Diseases · doi:10.1186/s12879-025-11580-4 · Cited by 4 · see citing works
- Authors
- Tang, F., Yuan, H., Li, X., & Qiao, L.
- Affiliations
- Sichuan University (CN)
- Corresponding author
- Qiao, Lina
- Venue
- International Immunopharmacology
- Publisher
- Elsevier BV
- Published
- 2024-03
- Volume
- 129
- Pages
- 111616
- ISSN
- 1567-5769 (ISSN-L)
- OpenAlex
- W4391506708
- Cited by
- 48
- References
- 4
- Citations by year
- 2026: 30 · 2025: 16 · 2024: 2
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- International Immunopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (82071353)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Pharmacology › Antibiotics Pharmacokinetics and Efficacy
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Keywords
- sepsis, septic shock, delayed antibiotic administration, timing of antibiotic administration, in-hospital mortality, 28-day mortality, 90-day mortality, one-year mortality, emergency department triage, sepsis treatment guidelines, mortality, sepsis mortality prediction model, sepsis severity score
- MeSH terms
- Anti-Bacterial Agents, Humans, Prospective Studies, Retrospective Studies, Shock, Septic, Time Factors, Treatment Outcome, Hospital Mortality, Sepsis, Time-to-Treatment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
