Augmentin

[Carlos Danger]

It states 3 hours here
http://www.survivingsepsis.org/Bundles/Documents/SSC_Bundle.pdf

I knew I'd seen 3 hours somewhere. I also remember hearing some discussion somewhere about how they'd changed the recommendation to 3 hours, because the available evidence didn't show any better outcomes among those who received it in 1 hour, vs. those who received it up to 3 hours.

But if you go to this page, and click on "Initial Resuscitation & Infection Issues" and scroll down to "D - Antimicrobial Therapy", the document states "Administration of effective intravenous antimicrobials within the first hour of recognition of septic shock (grade 1B) and severe sepsis without septic shock (grade 1C) as the goal of therapy."

I agree that any way you look at it, it stands to reason that giving them earlier rather than later is a good practice, even if that isn't necessarily supported by the best evidence. And it certainly shouldn't take longer than an hour after recognition to draw cultures and give ABX, anyway.

 

[Ewok Jerky]

It states 3 hours here
http://www.survivingsepsis.org/Bundles/Documents/SSC_Bundle.pdf

But that doesn't mean one hour isn't better. Where's you see one hour? I know it is the goal in our hospital but not sure where they got that from.

Their very own guidelines (which I think is the link that Halothane posted) states ABX in 1 hour.

Bringing the conversation back to pre-hospital use of ABX, this study found mortality was not related to time from triage to ABX, but it WAS linked to time to APPROPRIATE ABX. In the context of this thread, pre-hospital ABX will probly have no effect on mortality. Getting the Pt to the hospital for a culture and appropriate ABX will.

Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med. 2010 Apr;38(4):1045-53

 

[the_negro_puppy]

We carry Ceftriaxone but can only give it for suspected Menigicoccal Septicaemia IV / IM

 

[vasile]

Thank you very much guys for your opinions and advices,the reason I asked is that I wanted to find out if any of the ambulance services implemented antibiotic treatment for sepsis and if the specific guidelines could have an aplicability in other areas.Here in Ireland Augmentin for non community acquired sepsis is the drug of choice in A@E.Curently the treatment for sepsis in prehospital environment is high flow O2,NaCl(0.9) 500 ml iv with subsequent aliquots of 250 and if meningogocal suspected ,Penicilin G (benzopenicilin) 1200 mg iv.Many thanks!

 

[Nattens]

We carry Ceftriaxone but can only give it for suspected Menigicoccal Septicaemia IV / IM

Same thing down south as well.

We can consult for it's use in severe sepsis but more often than not you'll be shut down.