Antibiotic De-escalation and 30-day mortality in patients with suspected bacterial culture-negative Sepsis
Main finding · 30-day mortalityResult — go to the resultAdjusted odds ratio 0.92 95% CI 0.79–1.07Authors' conclusion
Antibiotic de-escalation was not associated with increased 30-day mortality across SOFA change groups.
Study context
- Population
- Adults with community-onset sepsis (CDC Adult Sepsis Event criteria) and negative bacterial cultures, Duke Health System, 2016–2023
- Participants
- 7,741 adults
- Exposure
- Antibiotic de-escalation vs no de-escalation
- De-escalationn = 4,806
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsmultivariable regression, stratified by SOFA change
- Multivariable regression
- Stratified by SOFA change
Main finding
As reported in the abstract
Adjusted odds ratio
0.92
95% CI 0.79–1.07
De-escalation vs No de-escalation
aOR 0.92 (95% CI 0.79–1.07)
- Crude 30-day mortality rate (overall)
- 17%
Observational data: associations, not effects.
Further findings
30-day mortality by SOFA change strata (subgroup)
- Findings similar across SOFA change strata
SOFA change from day 1 to day 3
- SOFA-improved
- 33%
- SOFA-unchanged
- 59%
- SOFA-deteriorated
- 8%
Antibiotic de-escalation occurrence · within 5 days of onset
- De-escalation occurred
- 62%
- 4806 patients
Original publication
Antibiotic De-escalation and 30-day mortality in patients with suspected bacterial culture-negative Sepsis. J Crit Care. Published 1 June 2026. doi:10.
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