2026-04-27T01:59:28Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/225442025-03-25T09:28:39Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967col_20.500.12105_16987

00925njm 22002777a 4500 dc Ferrer, Ricard author Luisa Martinez, Maria author Goma, Gemma author Suarez, David author Alvarez-Rocha, Luis author Victoria de la Torre, Maria author Gonzalez, Gumersindo author Zaragoza, Rafael author Borges Sa, Marcio author Blanco, Jesús author Palencia Herrejon, Eduardo author Artigas, Antonio author ABISS-Edusepsis Study Grp author 2018-06-22 Background: Early appropriate antibiotic treatment is essential in sepsis. We aimed to evaluate the impact of a multifaceted educational intervention to improve antibiotic treatment. We hypotheyzed that the intervention would hasten and improve the appropriateness of empirical antibiotic administration, favor de-escalation, and decrease mortality. Methods: We prospectively studied all consecutive patients with sepsis/septic shock admitted to 72 intensive care units (ICUs) throughout Spain in two 4-month periods (before and immediately after the 3-month intervention). We compared process-of-care variables (resuscitation bundle and time-to-initiation, appropriateness, and de-escalation of empirical antibiotic treatment) and outcome variables between the two cohorts. The primary outcome was hospital mortality. We analyzed the intervention's long-term impact in a subset of 50 ICUs. Results: We included 2628 patients (age 64.1 +/- 15.2 years; men 64.0%; Acute Physiology and Chronic Health Evaluation (APACHE) II, 22.0 +/- 8.1): 1352 in the preintervention cohort and 1276 in the postintervention cohort. In the postintervention cohort, the mean (SD) time from sepsis onset to empirical antibiotic therapy was lower (2.0 (2.7) vs. 2.5 (3.6) h; p= 0.002), the proportion of inappropriate empirical treatments was lower (6.5% vs. 8.9%; p= 0.024), and the proportion of patients in whom antibiotic treatment was de-escalated was higher (20.1% vs. 16.3%; p= 0.004); the expected reduction in mortality did not reach statistical significance (29.4% in the postintervention cohort vs. 30.5% in the preintervention cohort; p= 0.544). Gains observed after the intervention were maintained in the long-term follow-up period. Conclusions: Despite advances in sepsis treatment, educational interventions can still improve the delivery of care; further improvements might also improve outcomes. Ferrer R, Luisa Martinez M, Goma G, Suarez D, Alvarez-Rocha L, De la Torre MV, et al. Improved empirical antibiotic treatment of sepsis after an educational intervention: the ABISS-Edusepsis study. Crit Care. 2018 Jun 22;22:167. 1466-609X http://hdl.handle.net/20.500.13003/9244 https://hdl.handle.net/20.500.12105/22544 29933756 10.1186/s13054-018-2091-0 1364-8535 Critical Care 2-s2.0-85049004502 435886400001 L622659266 Sepsis Septic shock Quality improvement Timing of antibiotics De-escalation Hospital mortality Improved empirical antibiotic treatment of sepsis after an educational intervention: the ABISS-Edusepsis study