## Sepsis Antibiotic Timing — Surviving Sepsis Campaign 2021 **Key Point:** The 2021 Surviving Sepsis Campaign guidelines recommend administration of broad-spectrum IV antibiotics **within 1 hour** of recognition of sepsis and septic shock. This represents a tightening from the previous 3-hour window (2016 guidelines). **High-Yield:** Early antibiotic administration is one of the most impactful interventions in sepsis management. Every hour of delay is associated with increased mortality, particularly in septic shock. **Clinical Pearl:** The "golden hour" concept emphasizes that time-sensitive interventions — antibiotics, fluid resuscitation, vasopressors, and source control — must be initiated rapidly. In septic shock, mortality increases by approximately 7–10% for every hour of delayed antibiotic therapy. ## Timeline of Sepsis Antibiotic Guidelines | Guideline Version | Year | Antibiotic Timing | | --- | --- | --- | | Surviving Sepsis 2012 | 2012 | Within 3 hours | | Surviving Sepsis 2016 | 2016 | Within 3 hours | | Surviving Sepsis 2021 | 2021 | Within 1 hour | **Mnemonic:** **HOUR-1** — **H**igh mortality if delayed, **O**ne hour is the target, **U**rgent broad-spectrum coverage, **R**esuscitation bundle, **1** hour = golden standard. **Warning:** Do not confuse the 1-hour window for septic shock with the 3-hour window sometimes cited for severe sepsis in older guidelines. Current practice emphasizes 1 hour for both.
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