Presenting Symptoms and Antibiotic Timing Among Hospitalized Adults With Presumed Sepsis
Authors' conclusion
In this cohort study of 29 647 adults presenting with community-onset presumed bacterial sepsis, presenting symptoms were associated with timing of antibiotic therapy. Even after adjusting for presenting symptoms, timely antibiotics remained associated with lower mortality.
Study context
- Population
- Adults hospitalized for community-onset presumed bacterial sepsis at 67 hospitals, Michigan Medicine Safety Consortium, November 2020 to May 2024
- Participants
- 29,647 adults · 67 hospitals
- Exposure
- Presenting symptoms and their association with timely antibiotics
- With hypotensionn = 6,704
- Without hypotensionn = 22,942
- Outcome
- Timely antibiotics (within 3 h of presentation with hypotension, within 5 h without hypotension)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Timely antibiotics by presenting symptom
Adjusted odds ratio (95% CI)
Prehospital fever (with hypotension)
1.34(1.19–1.52)
Prehospital fever (without hypotension)
1.26(1.17–1.35)
Gastrointestinal symptoms (with hypotension)
0.84(0.75–0.94)
Gastrointestinal symptoms (without hypotension)
0.80(0.75–0.86)
Urinary symptoms (without hypotension)
1.13(1.05–1.22)
Respiratory symptoms (without hypotension)
0.91(0.85–0.99)
Observational data: associations, not effects.
Secondary outcomes
30-day mortality, timely vs not timely antibiotics (overall cohort, adjusted for presenting symptoms)
| Adjusted absolute difference (percentage points) (95% CI) | ||
|---|---|---|
| Timely antibiotics | −2.10 (−3.01 to −1.10) | |
| −4−202Difference, percentage points (linear scale) |
Original publication
Presenting Symptoms and Antibiotic Timing Among Hospitalized Adults With Presumed Sepsis. JAMA Netw Open. Published 1 September 2026. doi:10.
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