A critical assessment of time-to-antibiotics recommendations in pediatric sepsis

Abstract The Pediatric Surviving Sepsis Campaign (SSC) Guidelines recommend delivery of antibiotics within one hour for children with septic shock and, for those without shock but with sepsis-related organ dysfunction, as soon as feasible within three 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.