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Cumulative Initiation of Effective Antimicrobial Therapy and Survival in Septic Shock

Cumulative Initiation of Effective Antimicrobial Therapy and Survival in Septic Shock. survival fraction. 1.0. cumulative antibiotic. initiation. 0.8. 0.6. fraction of total patients. 0.4. 0.2. 0.0. 12-24. 24-36. 0-0.5. 0.5-1. 9-12. 36+. 1-2. 2-3. 3-4. 4-5. 5-6. 6-9.

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Cumulative Initiation of Effective Antimicrobial Therapy and Survival in Septic Shock

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  1. Cumulative Initiation of Effective Antimicrobial Therapy and Survival in Septic Shock survival fraction 1.0 cumulative antibiotic initiation 0.8 0.6 fraction of total patients 0.4 0.2 0.0 12-24 24-36 0-0.5 0.5-1 9-12 36+ 1-2 2-3 3-4 4-5 5-6 6-9 time from hypotension onset (hrs) Kumar et al. CCM. 2006:34:1589-96.

  2. Funk and Kumar, Critical Care Clinics 2011 (in press)

  3. 100 Odds Ratio of Death (95% Confidence Interval) 10 1 12-23.99 24-35.99 9-11.99 1-1.99 2-2.99 3-3.99 4-4.99 5-5.99 6-8.99 > 36 Time (hrs) Mortality Risk with Increasing Delays in Initiation of Effective Antimicrobial Therapy Kumar et al, CCM. 2006:34:1589-96.

  4. N Risk of Death with Increasing Antimicrobial Delays: Subgroups 2154 all documented 1695 459 suspected culture + 1546 608 culture - 769 bacteremia + bacteremia - 1385 community 1242 nosocomial 912 584 gram + 768 gram - fungal 131 Survival = 0.79/1.119xx = delay (hrs) 838 respiratory 230 urinary tract intra-abdominal 641 skin/soft tissue 156 1.0 1.1 1.2 1.3 Kumar et al, CCM. 2006:34:1589-96. Adjusted Odds Ratio of Death

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