Blood culture collection and administration of intravenous ceftriaxone by paramedics in patients with suspected sepsis (the pass trial).

Cudini, Daniel; Smith, Karen; Shao, Jeffery; Bernard, Stephen; Okyere, Daniel; Nehme, Ziad; Nehme, Emily; Anderson, David; Magnuson, Nicole; Thursky, Karin; Mori, Dhruv; Oosthuizen, De Witt; Udy, Andrew

doi:10.1111/1742-6723.70027

Blood culture collection and administration of intravenous ceftriaxone by paramedics in patients with suspected sepsis (the pass trial).

Daniel Cudini, Karen Smith, Jeffery Shao, Stephen Bernard, Daniel Okyere, Ziad Nehme, Emily Nehme, David Anderson, Nicole Magnuson, Karin Thursky and 3 more

Emergency medicine Australasia · 2025-03-18 · Randomised trial

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Abstract

OBJECTIVE: To evaluate the feasibility of pre-hospital blood culture (BC) collection and intravenous (IV) antibiotic administration in patients with suspected sepsis. METHODS: In this open-label trial, BCs were collected in all participants, who were then randomised to ongoing care (control) or ongoing care plus 2 g IV ceftriaxone (intervention). Time to antibiotic administration was the primary outcome. RESULTS: Thirty-five patients were enrolled and randomised (21 control, 14 intervention). BCs were obtained in 89% (n = 31/35) and grew a pathogen in 42% (n = 13/31). Intervention patients received antibiotics a median of 108 (95% CI 34 to 170) minutes earlier (P < 0.01). CONCLUSION: BCs were successfully obtained by paramedics, and pre-hospital IV ceftriaxone resulted in expedited antibiotic administration. CLINICAL TRIAL REGISTRATION: ACTRN12618000199213.

Blood culture collection and administration of intravenous ceftriaxone by paramedics in patients with suspected sepsis (the pass trial).

Abstract

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