Association of Antibiotics Administration Timing With Mortality in Children With Sepsis in a Tertiary Care Hospital of a Developing Country
Objective: To investigate the association between antibiotics administration timing with morbidity and mortality in children with severe sepsis and septic shock, presenting to a tertiary care center in a developing country.Methods: This is a retrospective study of children aged 14 years or younger d...
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doaj-d08e3df9e7c045a09f26ba124795a0b32020-11-25T03:11:49ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-09-01810.3389/fped.2020.00566579320Association of Antibiotics Administration Timing With Mortality in Children With Sepsis in a Tertiary Care Hospital of a Developing CountryAlaa Alsadoon0Moudi Alhamwah1Bassam Alomar2Sara Alsubaiel3Adel F. Almutairi4Adel F. Almutairi5Ramesh K. Vishwakarma6Ramesh K. Vishwakarma7Nesrin Alharthy8Nesrin Alharthy9Nesrin Alharthy10Yasser M. Kazzaz11Yasser M. Kazzaz12Yasser M. Kazzaz13Department of Pediatrics, Ministry of National Guards—Health Affairs, Riyadh, Saudi ArabiaDepartment of Pediatrics, Ministry of National Guards—Health Affairs, Riyadh, Saudi ArabiaPediatrics Emergency Department, Ministry of National Guards—Health Affairs, Riyadh, Saudi ArabiaDepartment of Pediatrics, Ministry of National Guards—Health Affairs, Riyadh, Saudi ArabiaKing Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaScience and Technology Unit, King Abdullah International Medical Research Center, Riyadh, Saudi ArabiaKing Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaDepartment of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi ArabiaPediatrics Emergency Department, Ministry of National Guards—Health Affairs, Riyadh, Saudi ArabiaCollege of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaKing Abdullah International Medical Research Center, Riyadh, Saudi ArabiaDepartment of Pediatrics, Ministry of National Guards—Health Affairs, Riyadh, Saudi ArabiaKing Abdullah International Medical Research Center, Riyadh, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaObjective: To investigate the association between antibiotics administration timing with morbidity and mortality in children with severe sepsis and septic shock, presenting to a tertiary care center in a developing country.Methods: This is a retrospective study of children aged 14 years or younger diagnosed with severe sepsis or septic shock at a free-standing tertiary children's hospital in Saudi Arabia between April 2015 and February 2018. We investigated the association between antibiotic administration timing and pediatric intensive care unit (PICU) mortality, PICU length of stay (LOS), hospital LOS, and ventilation-free days after adjusting for confounders.Results: Among the 189 admissions, 77 patients were admitted with septic shock and 112 with severe sepsis. Overall, the mortality rate was 16.9%. The overall median time from sepsis recognition to antibiotic administration was 105 min (IQR: 65–185.5 min); for septic shock patients, it was 85 min (IQR: 55–148 min), and for severe sepsis, 130 min (IQR: 75.5–199 min). Delayed antibiotic administration (> 3 h) was associated with 3.85 times higher PICU mortality (95% confidence intervals 1.032–14.374) in children with septic shock than in children who receive antibiotics within 3 h, after controlling for severity of illness, age, comorbidities, and volume resuscitation. However, delayed antibiotics administration was not significantly associated with higher PICU mortality in children diagnosed with severe sepsis.Conclusions: Delayed antibiotics administration in children with septic shock admitted to a free-standing children's hospital in a developing country was associated with PICU mortality.https://www.frontiersin.org/article/10.3389/fped.2020.00566/fullSaudi Arabiachildrensepsisseptic shockpediatric intensive care unitsepsis resuscitation bundle |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alaa Alsadoon Moudi Alhamwah Bassam Alomar Sara Alsubaiel Adel F. Almutairi Adel F. Almutairi Ramesh K. Vishwakarma Ramesh K. Vishwakarma Nesrin Alharthy Nesrin Alharthy Nesrin Alharthy Yasser M. Kazzaz Yasser M. Kazzaz Yasser M. Kazzaz |
spellingShingle |
Alaa Alsadoon Moudi Alhamwah Bassam Alomar Sara Alsubaiel Adel F. Almutairi Adel F. Almutairi Ramesh K. Vishwakarma Ramesh K. Vishwakarma Nesrin Alharthy Nesrin Alharthy Nesrin Alharthy Yasser M. Kazzaz Yasser M. Kazzaz Yasser M. Kazzaz Association of Antibiotics Administration Timing With Mortality in Children With Sepsis in a Tertiary Care Hospital of a Developing Country Frontiers in Pediatrics Saudi Arabia children sepsis septic shock pediatric intensive care unit sepsis resuscitation bundle |
author_facet |
Alaa Alsadoon Moudi Alhamwah Bassam Alomar Sara Alsubaiel Adel F. Almutairi Adel F. Almutairi Ramesh K. Vishwakarma Ramesh K. Vishwakarma Nesrin Alharthy Nesrin Alharthy Nesrin Alharthy Yasser M. Kazzaz Yasser M. Kazzaz Yasser M. Kazzaz |
author_sort |
Alaa Alsadoon |
title |
Association of Antibiotics Administration Timing With Mortality in Children With Sepsis in a Tertiary Care Hospital of a Developing Country |
title_short |
Association of Antibiotics Administration Timing With Mortality in Children With Sepsis in a Tertiary Care Hospital of a Developing Country |
title_full |
Association of Antibiotics Administration Timing With Mortality in Children With Sepsis in a Tertiary Care Hospital of a Developing Country |
title_fullStr |
Association of Antibiotics Administration Timing With Mortality in Children With Sepsis in a Tertiary Care Hospital of a Developing Country |
title_full_unstemmed |
Association of Antibiotics Administration Timing With Mortality in Children With Sepsis in a Tertiary Care Hospital of a Developing Country |
title_sort |
association of antibiotics administration timing with mortality in children with sepsis in a tertiary care hospital of a developing country |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pediatrics |
issn |
2296-2360 |
publishDate |
2020-09-01 |
description |
Objective: To investigate the association between antibiotics administration timing with morbidity and mortality in children with severe sepsis and septic shock, presenting to a tertiary care center in a developing country.Methods: This is a retrospective study of children aged 14 years or younger diagnosed with severe sepsis or septic shock at a free-standing tertiary children's hospital in Saudi Arabia between April 2015 and February 2018. We investigated the association between antibiotic administration timing and pediatric intensive care unit (PICU) mortality, PICU length of stay (LOS), hospital LOS, and ventilation-free days after adjusting for confounders.Results: Among the 189 admissions, 77 patients were admitted with septic shock and 112 with severe sepsis. Overall, the mortality rate was 16.9%. The overall median time from sepsis recognition to antibiotic administration was 105 min (IQR: 65–185.5 min); for septic shock patients, it was 85 min (IQR: 55–148 min), and for severe sepsis, 130 min (IQR: 75.5–199 min). Delayed antibiotic administration (> 3 h) was associated with 3.85 times higher PICU mortality (95% confidence intervals 1.032–14.374) in children with septic shock than in children who receive antibiotics within 3 h, after controlling for severity of illness, age, comorbidities, and volume resuscitation. However, delayed antibiotics administration was not significantly associated with higher PICU mortality in children diagnosed with severe sepsis.Conclusions: Delayed antibiotics administration in children with septic shock admitted to a free-standing children's hospital in a developing country was associated with PICU mortality. |
topic |
Saudi Arabia children sepsis septic shock pediatric intensive care unit sepsis resuscitation bundle |
url |
https://www.frontiersin.org/article/10.3389/fped.2020.00566/full |
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