New retrospective studies continue to claim that each hour delay in antibiotic administration significantly increases mortality in sepsis and septic shock, implying that any patient with a hint of sepsis should receive antibiotics immediately. However, both sepsis and septic shock can present with widely variable clinical features, making diagnosis challenging. This blog explores the current evidence regarding the time to antibiotic administration in sepsis and septic shock.

Order blood cultures in clinically deteriorating patients, not just when fever or CRP is elevated. Fever timing doesn’t increase yield, and modern techniques detect bacteria regardless of symptoms. Proper blood volume is key—draw at least 2 sets (preferably 3) with 8–10 mL per bottle. A single-draw strategy is efficient and reduces patient discomfort. Avoid routine cultures for all fevers or low-risk infections; follow guidelines and use clinical judgment to guide testing.