Impact of Time to Antibiotics on In-hospital Mortality in Neutropenic Sepsis: A Prospective Multicenter Cohort Study
Authors' conclusion
Delayed antibiotic administration was associated with increased in-hospital mortality among patients with neutropenic sepsis. The impact on in-hospital mortality is heterogeneous, varying by patient characteristics, particularly septic shock and hematologic malignancy.
Study context
- Population
- Patients with sepsis and neutropenia, 20 tertiary or university-affiliated hospitals in South Korea
- Participants
- 942 patients · 20 hospitals
- Exposure
- Time to antibiotics 1-3 h or ≥3 h vs <1 h
- Earlyn = 211reference
- Intermediaten = 531
- Delayedn = 200
- Outcome
- In-hospital mortality
Methodological detailsmulticenter, observational, inverse probability of treatment weighting, causal forest model
- Multicenter
- Observational
- Inverse probability of treatment weighting
- Causal forest model
Main finding
As reported in the abstract
Each group vs earlyOdds ratio (95% CI)P value
Delayed
1.50(1.22–1.85)
P < 0.001Intermediate
1.26(1.04–1.53)
P = 0.021Observational data: associations, not effects.
Further findings
Effect modification of time to antibiotics (TTA)–mortality association (subgroups)
- Association stronger among patients with septic shock and with hematologic malignancy in both models
- Causal forest identified elevated lactate as potential effect modifier; interaction tests in weighted logistic model not significant
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Impact of Time to Antibiotics on In-hospital Mortality in Neutropenic Sepsis: A Prospective Multicenter Cohort Study. Crit Care Med. Published 3 June 2026. doi:10.
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