A Critical Assessment of Time-to-Antibiotics Recommendations in Pediatric Sepsis

The Pediatric Surviving Sepsis Campaign Guidelines recommend delivery of antibiotics within 1 hour for children with septic shock and, for those without shock but with sepsis-related organ dysfunction, as soon as feasible within 3 hours. In this review, we summarize the available adult and pediatric literature supporting these recommendations. We also explore the implications of implementing time-to-antibiotic goals at the point of antibiotic initiation in clinical practice, as well as the potential downstream impacts of these goals on antibiotic de-escalation.