Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a guideline (underpinned by a systematic review) that focuses on the above important clinical question.
Confidence in the evidence is very low or low where GRADE has been performed and the intervention may be more effective/beneficial than the comparison for key outcomes. However, this is uncertain and new evidence could change this in the future.
Population: Adults with or at risk of developing sepsis or severe sepsis
Intervention: Early initiation of empiric antimicrobial treatment
Comparison: Late initiation of empiric antimicrobial treatment
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
<1 hour versus >1 hour | ||
Mortality ᵃ | Favours intervention | Very Low |
Mortality - Intensive Care Unit (ICU) setting | Favours intervention | Very Low |
Mortality - Emergency Department (ED) setting | No statistically significant difference | Very Low |
<2 hours versus >2 hours | ||
Mortality ᵃ | No statistically significant difference | Very Low |
Mortality - ICU setting | Favours intervention | Very Low |
Mortality - ED setting | No statistically significant difference | Very Low |
<3 hours versus >3 hours | ||
Mortality ᵃ | Favours intervention | Very Low |
Mortality - ICU setting | No statistically significant difference | Very Low |
Mortality - ED setting | Favours intervention | Very Low |
<4 hours versus >4 hours | ||
Mortality - ED setting | No statistically significant difference | Very Low |
<5 hours versus >5 hours | ||
Mortality - ED setting | No statistically significant difference | Very Low |
<6 hours versus >6 hours | ||
Mortality ᵃ | Favours intervention | Very Low |
Mortality - ICU setting | No statistically significant difference | Very Low |
Mortality - ED setting | Favours intervention | Very Low |
Recommendations as stated in the source guideline The guideline committee recommends that adults, children, and young people over the age of 12 who have suspected sepsis and one or more high-risk criteria, should be given a broad-spectrum antimicrobial at the maximum recommended dose without delay (within 1 hour of establishing they meet high-risk criteria in an acute hospital setting).ᵇ See guideline for details on criteria for different levels of risk.
Note Results in this table are based on observational studies only. ᵃ Includes overall mortality in intensive care and emergency department settings. ᵇ This guideline recommends that all people with suspected sepsis have a face-to-face assessment and a risk stratification tool is used to determine risk of severe illness and death from sepsis. Recommendations depend on the presence and number of high-, moderate-to-high, and low-risk criteria.
This evidence table is related to the following section/s:
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