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.
Semler MW, Andrews B, Bernard GR. Early Resuscitation for Adults With Sepsis in a Low-income Country—Reply. JAMA. 2018;319(6):614–615. doi:10.1001/jama.2017.20410
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: