- •Electronic sepsis screening and treatment protocols may have unintended effects.
- •Unintended effects include increased antibiotic use and health care facility–onset Clostridium difficile infection (CDI).
- •We assessed these effects on 4 medicine wards in a large, tertiary, urban hospital.
- •Sepsis screening implementation coincided with increased antibiotic use and CDI.
- •Further study of unintended effects of sepsis screening is warranted.
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to American Journal of Infection Control
- Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012.JAMA. 2014; 311: 1308-1316
- Benchmarking the incidence and mortality of severe sepsis in the United States.Crit Care Med. 2013; 41: 1167-1174
- Two decades of mortality trends among patients with severe sepsis: a comparative meta-analysis.Crit Care Med. 2014; 42: 625-631
- Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012.Crit Care Med. 2013; 41: 580-637
- Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock.Crit Care Med. 2006; 34: 1589-1596
- The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis.Intensive Care Med. 2010; 36: 222-231
- Surviving sepsis campaign: association between performance metrics and outcomes in a 7.5-year study.Crit Care Med. 2015; 43: 3-12
- Multicenter implementation of a severe sepsis and septic shock treatment bundle.Am J Respir Crit Care Med. 2013; 188: 77-82
- Effect of performance improvement programs on compliance with sepsis bundles and mortality: a systematic review and meta-analysis of observational studies.PLoS ONE. 2015; 10 (e0125827)
- Regulatory mandates for sepsis care–reasons for caution.N Engl J Med. 2014; 370: 1673-1676
- Increase in adult Clostridium difficile-related hospitalizations and case-fatality rate, United States, 2000-2005.Emerg Infect Dis. 2008; 14: 929-931
- Multistate point-prevalence survey of health care-associated infections.N Engl J Med. 2014; 370: 1198-1208
- Recommendations for surveillance of Clostridium difficile-associated disease.Infect Control Hosp Epidemiol. 2007; 28: 140-145
- Segmented regression analysis of interrupted time series studies in medication use research.J Clin Pharm Ther. 2002; 27: 299-309
- Development, implementation, and impact of an automated early warning and response system for sepsis.J Hosp Med. 2015; 10: 26-31
- The Surviving Sepsis Campaign bundles and outcome: results from the International Multicentre Prevalence Study on Sepsis (the IMPreSS study).Intensive Care Med. 2015; 41: 1620-1628
- Iatrogenic salt water drowning and the hazards of a high central venous pressure.Ann Intensive Care. 2014; 4: 21
- Comparison of two fluid-management strategies in acute lung injury.N Engl J Med. 2006; 354: 2564-2575
- Mortality after fluid bolus in African children with severe infection.N Engl J Med. 2011; 364: 2483-2495
- The importance of fluid management in acute lung injury secondary to septic shock.Chest. 2009; 136: 102-109
- Fluid balance and cardiac function in septic shock as predictors of hospital mortality.Crit Care. 2013; 17: R246
- Simplified severe sepsis protocol: a randomized controlled trial of modified early goal-directed therapy in Zambia.Crit Care Med. 2014; 42: 2315-2324
- An electronic tool for the evaluation and treatment of sepsis in the ICU: a randomized controlled trial.Crit Care Med. 2015; 43: 1595-1602
- Electronic medical alerts–so simple, so complex.N Engl J Med. 2005; 352: 1034-1036
- Computerized physician order entry and online decision support.Acad Emerg Med. 2004; 11: 1135-1141
- Misdiagnosis of community-acquired pneumonia and inappropriate utilization of antibiotics - side effects of the 4-h antibiotic administration rule.Chest. 2007; 131: 1865-1869
- Hospital-reported data on the pneumonia quality measure “Time to First Antibiotic Dose” are not associated with inpatient mortality: results of a nationwide cross-sectional analysis.Acad Emerg Med. 2011; 18: 496-503
- Diagnostic accuracy and effectiveness of automated electronic sepsis alert systems: a systematic review.J Hosp Med. 2015; 10: 396-402
- The golden hour of antibiotic administration in severe sepsis: avoid a false start striving for gold.Crit Care Med. 2014; 42: 1931-1932
- A randomized trial of protocol-based care for early septic shock.N Engl J Med. 2014; 370: 1683-1693
- Timing of antibiotics, volume, and vasoactive infusions in children with sepsis admitted to intensive care.Crit Care. 2015; 19: 293
- The impact of timing of antibiotics on outcomes in severe sepsis and septic shock: a systematic review and meta-analysis.Crit Care Med. 2015;
- Comparison of trends in sepsis incidence and coding using administrative claims versus objective clinical data.Clin Infect Dis. 2015; 60: 88-95
- Impact of policies on the rise in sepsis incidence, 2000-2010.Clin Infect Dis. 2016; 62: 695-703
- The impact of an electronic medical record surveillance program on outcomes for patients with sepsis.Heart Lung. 2014; 43: 546-549
- Systematic screening is essential for early diagnosis of severe sepsis and septic shock.Rev Bras Ter Intensiva. 2015; 27: 96-101
- An evaluation of the impact of antibiotic stewardship on reducing the use of high-risk antibiotics and its effect on the incidence of Clostridium difficile infection in hospital settings.J Antimicrob Chemother. 2012; 67: 2988-2996
- Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent NAP1/027 strain.Clin Infect Dis. 2007; 45: S112-21
- Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years.Infect Control Hosp Epidemiol. 2003; 24: 699-706
- Clostridium difficile infection.N Engl J Med. 2015; 372: 1539-1548
- Hospital ward antibiotic prescribing and the risks of Clostridium difficile infection.JAMA Intern Med. 2015; 175: 626-633
- Antibiotics and hospital-acquired Clostridium difficile infection: update of systematic review and meta-analysis.J Antimicrob Chemother. 2014; 69: 881-891
- Alarm fatigue: clearing the air.J Hosp Med. 2016; 11: 153-154
- EMR alert cuts sepsis deaths.CMAJ. 2014; 186: E80
- Impact of an in-patient electronic clinical decision support tool on sepsis-related mortality.Crit Care Med. 2014; 42
- Guideline bundles adherence and mortality in severe sepsis and septic shock.Crit Care Med. 2014; 42: 1890-1898
Conflicts of interest: None to report.