Supportive Care in Cancer

, Volume 25, Issue 11, pp 3357–3363 | Cite as

Timing to antibiotic therapy in septic oncologic patients presenting without hypotension

  • Kathleen MorneauEmail author
  • Gary B. Chisholm
  • Frank Tverdek
  • Jeffrey Bruno
  • Katy M. Toale
Original Article



Sepsis accounts for only 2% of the hospitalizations worldwide but more than 17% of total in-hospital mortality. Inappropriate antimicrobial selection and delays in appropriate therapy have been associated with reduced survival in severe sepsis and septic shock. No studies to date have exclusively targeted septic oncologic patients without hypotension.


This study was a retrospective chart review of 100 adult cancer patients presenting to the emergency department with sepsis without hypotension. We investigated the effect of time to appropriate antibiotics on in-hospital mortality and hospital length of stay. It was hypothesized that increased time to antibiotic administration would worsen patient outcomes including in-hospital mortality and length of stay.


Each 1-h delay in administration of appropriate antibiotic therapy increased the odds of in-hospital mortality by 16% (adjusted OR 1.16. 95% CI 1.04–1.34, p = 0.04). Time to appropriate antibiotics had no effect on hospital length of stay.


Time to appropriate antibiotics and in-hospital mortality were associated in this population of adult oncologic patients with sepsis without hypotension. Clinicians in the emergency department should strive to ensure the timely administration of a complete and appropriate empiric antibiotic regimen in septic patients with active cancer even in the absence of hypotension.


Sepsis Hypotension Antibiotics Timing Mortality Cancer 



The authors would like to thank Kelly Merriman, MPH, Ph.D., for her contributions over the course of the study.

Compliance with ethical standards

The study was approved by the institutional review board, and the need for informed consent was waived.

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of PharmacyThe University of Texas M.D. Anderson Cancer CenterHoustonUSA
  2. 2.Michael E. DeBakey VA Medical CenterHoustonUSA
  3. 3.Department of BiostatisticsThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

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