Infectious disease/editorial
The 2018 Surviving Sepsis Campaign’s Treatment Bundle: When Guidelines Outpace the Evidence Supporting Their Use

https://doi.org/10.1016/j.annemergmed.2018.06.046Get rights and content

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    In fact, it is well established that septic shock mortality and morbidity are lowered by earlier antibiotic therapy starting from either the in-hospital [32-34] or the prehospital setting [13]. Despite controversies [35], since 2004, international guidelines recommend starting antibiotic therapy within the first 3 h or even within the first 1 h if possible [8,25,36-39]. However, a consensual real T0 time for “1-h bundle” initiation is difficult to determine between studies because of difficulties in initial sepsis severity assessment.

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Supervising editor: Donald M. Yealy, MD

Authorship: All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist.

Dr. Kenny is the chief medical officer for Flosonics Medical, but this in no way conflicts with the opinions written in this editorial.

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