A RECENT study sheds light on the timing of antibiotic administration in patients with suspected sepsis, suggesting that giving β-lactam antibiotics before vancomycin may lead to better outcomes. This retrospective analysis, covering data from 25,391 patients across five U.S. hospitals from 2015 to 2022, examined the sequence of these two antibiotics and its impact on in-hospital mortality.
The research found that 84.4% of patients received β-lactams first, while 15.6% received vancomycin first. Interestingly, those who received vancomycin initially were less severely ill and tended to have skin and musculoskeletal infections. Despite this, the study revealed that the β-lactam-first approach was associated with a modest reduction in mortality (adjusted odds ratio of 0.89), suggesting it could improve survival rates in suspected sepsis cases.
While the results are promising, the authors caution that these findings are observational and warrant further validation through randomized controlled trials. Despite this, the evidence supports prioritizing β-lactam therapy for most sepsis patients to improve survival outcomes, especially in cases involving serious bacterial infections.
The study highlights the importance of timely and strategic antibiotic use in sepsis management, emphasizing that small changes in antibiotic sequencing can have a significant impact on patient survival. Healthcare professionals should consider these findings when making treatment decisions for sepsis patients, though further research is needed to confirm these findings.
Reference: Kondo Y et al. Association Between the Sequence of β-lactam and Vancomycin Administration and Mortality in Patients with Suspected Sepsis. Clin Infect Dis. 2024;ciae599.
Anaya Malik | AMJ
