Performance of Prehospital Antibiotic Administration and Blood Culture Collection in a Physician-Staffed Mobile Unit: A Retrospective Cohort Study.
Prehospital Emergency Care · 2025-08-13 · Observational study
Abstract
OBJECTIVES: Prehospital antibiotic administration prior to emergency department (ED) admission could reduce the delay of effective antibiotic treatment and thus mortality of septic patients. Additionally, collecting blood cultures early could improve microbial identification. We assessed the effect of ceftriaxone administration before ED admission on mortality. As our secondary objective, we evaluated the positivity and contamination rate of prehospital blood cultures in a prehospital physician-staffed system. METHODS: The computerized databases of a physician-staffed prehospital unit were screened for patients presenting with suspected sepsis and low systolic blood pressure (< 90 mmHg) between May 2013 and December 2018. The association between prehospital ceftriaxone administration and 28-day mortality, Intensive care unit (ICU) admission and length-of-stay (LOS) was analyzed. The yield of blood cultures and frequency of contamination were calculated. RESULTS: A total of 165 septic patients matched the inclusion criteria. Prehospital antibiotics were administered in 60.6% (100/165) of cases. Twenty-eight-day mortality was similar between patients receiving and not receiving antibiotics (39.0 % vs 38.5%, p = 1.000). Hazard ratio of 28-day mortality was 0.87 (95%IC 0.51-1.47). Likewise, no statistically significant impact on 7-day mortality, ICU admission or LOS was found. Blood cultures showed a high positivity rate (35.4%, 23/65) and a low contamination rate (3.1%, 2/65). CONCLUSIONS: In a physician-staffed prehospital system, prehospital blood cultures among critically ill, septic patients showed high positivity and low contamination rates. However, early ceftriaxone administration showed no impact on 28-day mortality, 7-day mortality, ICU admission and ED and ICU LOS.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Antibiotics · Mortality & survival · Other drugs · Prehospital physicians
Related articles
- Impact of Prehospital Antibiotic Therapy on Septic Shock Mortality. (Prehosp Emerg Care, 2021)
- Adequacy of probabilistic prehospital antibiotic therapy for septic shock. (Am J Emerg Med, 2022)
- Prehospital Administration of Antibiotics for Patients with Suspected Severe Infection: A Systematic Review and Meta Analysis. (Antibiotics (Basel), 2026)
- Prehospital administration of broad-spectrum antibiotics for sepsis patients: A systematic review and meta-analysis. (Health Sci Rep, 2022)
- Association between early prehospital administration antibiotic and 28-day mortality in sepsis. (Prehosp Emerg Care, 2026)
- Direct admission to the intensive care unit for patients with prehospital septic shock is associated with a lower 30-day mortality rate. (Sci Rep, 2026)