This study raises the quesiton of whether or not people (just over 95,000 of them) with pneumonia who received antibiotics early had a lower mortality than those who got them later. In a nutshell the answer is: No. The mortality rates are pretty much the same no matter when you got your antibiotics. (Of course there some methodological issues with this paper, as well as the fact that the data is extracted from massive comined databases). But you can’t do a prospective randomised control trial of “early vs late antibiotics for your 4.10 now can you?
Does this mean we should wait until every blood test is back and the Med Reg has seen the patient before we give antibiotcs? No. Does it mean some people who get antibiotics within 5 minutes of coming in the door will still die up on the ward? Yes.
Does giving antibiotics early prevent morbidity? This study doesn’t answer that question but one would like to think so. So get in there early, get your cultures off quickly and get your antibiotics in asap, but don’t lose sleep over it if you’re a bit slow.