SEPSIS IN THE EMERGENCY DEPARTMENT: EARLY RECOGNITION, THE IMPACT OF TIME TO INITIAL ANTIBIOTIC THERAPY, AND ITS IMPORTANCE IN REDUCING MORTALITY
DOI:
https://doi.org/10.63330/aurumpub.068-066Keywords:
Antibiotic therapy, Early diagnosis, Emergency medical services, Mortality, SepsisAbstract
Sepsis is a major cause of morbidity and mortality in emergency departments and represents a significant challenge for healthcare professionals due to its rapid clinical progression and the risk of organ dysfunction and septic shock. Early recognition of clinical deterioration and timely initiation of treatment are essential to improving patient outcomes. This study aims to analyze the importance of early sepsis recognition in emergency departments and the relationship between time to initial empirical antibiotic administration and mortality reduction. This is a bibliographic and documentary review adopting a qualitative, descriptive, and exploratory approach, based on scientific publications and international guidelines addressing sepsis diagnosis, initial management, and clinical outcomes. The literature indicates that recognizing clinical abnormalities suggestive of infection associated with organ dysfunction, systematically assessing disease severity, and implementing clinical protocols facilitate the identification of patients at increased risk of adverse outcomes. Early administration of appropriate antimicrobial therapy is particularly important in septic shock and in patients with a high likelihood of sepsis, in whom treatment delays may be associated with increased mortality. However, decisions regarding antibiotic initiation should consider clinical severity, the likelihood of infection, appropriate antimicrobial selection, and antimicrobial stewardship principles, thereby avoiding unnecessary treatment in patients without sufficient evidence of bacterial infection. The findings also emphasize the importance of coordinated multidisciplinary care, continuous monitoring, and well-organized emergency workflows to minimize treatment delays. It is concluded that early sepsis recognition, combined with timely and appropriate antibiotic therapy, is an essential strategy for improving emergency care and contributing to mortality reduction, particularly among critically ill patients.
Downloads
References
BARDIN, Laurence. Análise de conteúdo. São Paulo: Edições 70, 2016.
EVANS, Laura et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Medicine, v. 47, n. 11, p. 1181-1247, 2021. DOI: https://doi.org/10.1007/s00134-021-06506-y.
FERRER, Ricard et al. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program. Critical Care Medicine, v. 42, n. 8, p. 1749-1755, 2014. DOI: https://doi.org/10.1097/CCM.0000000000000330.
GIL, Antonio Carlos. Métodos e técnicas de pesquisa social. 6. ed. São Paulo: Atlas, 2008.
KUMAR, Anand et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Critical Care Medicine, v. 34, n. 6, p. 1589-1596, 2006. DOI: https://doi.org/10.1097/01.CCM.0000217961.75225.E9.
LIU, Vincent X. et al. The timing of early antibiotics and hospital mortality in sepsis. American Journal of Respiratory and Critical Care Medicine, v. 196, n. 7, p. 856-863, 2017. DOI: https://doi.org/10.1164/rccm.201609-1848OC.
MINAYO, Maria Cecília de Souza. O desafio do conhecimento: pesquisa qualitativa em saúde. 14. ed. São Paulo: Hucitec, 2014.
RUDD, Kristina E. et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. The Lancet, v. 395, n. 10219, p. 200-211, 2020. DOI: https://doi.org/10.1016/S0140-6736(19)32989-7.
SEYMOUR, Christopher W. et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, v. 315, n. 8, p. 762-774, 2016. DOI: https://doi.org/10.1001/jama.2016.0288.
SEYMOUR, Christopher W. et al. Time to treatment and mortality during mandated emergency care for sepsis. The New England Journal of Medicine, v. 376, n. 23, p. 2235-2244, 2017. DOI: https://doi.org/10.1056/NEJMoa1703058.
SHANKAR-HARI, Manu et al. Developing a new definition and assessing new clinical criteria for septic shock: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, v. 315, n. 8, p. 775-787, 2016. DOI: https://doi.org/10.1001/jama.2016.0289.
SINGER, Mervyn et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, v. 315, n. 8, p. 801-810, 2016. DOI: https://doi.org/10.1001/jama.2016.0287.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
