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Comment & Response
February 13, 2018

Early Resuscitation for Adults With Sepsis in a Low-income Country—Reply

Author Affiliations
  • 1Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
  • 2Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia
JAMA. 2018;319(6):614-615. doi:10.1001/jama.2017.20410

In Reply Drs Nedel and Deutschendorf highlight 2 key considerations for the interpretation of our trial and the management of patients with sepsis across settings: (1) timing of antibiotic administration and (2) volume of intravenous fluid.

First, Nedel and Deutschendorf point out that delays in antibiotic administration for patients with sepsis and hypotension have been consistently associated with higher mortality.1,2 They note that attempting to simultaneously deliver multiple therapies (eg, intravenous fluids, vasopressors, blood transfusion, and antibiotics) with limited clinical personnel and limited intravenous access could inadvertently delay antibiotic administration and worsen outcomes.