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Interestingly, outcome was not influenced by initiation of effective empiric therapy (data not shown).
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During the initial 6-hour period, overall survival fell by 7.6% for every hour that the initiation of effective antibiotic therapy was delayed.
In an interesting meta-analysis of 16 studies, bacteremias caused by ESBL-producing pathogens were significantly associated with delayed initiation of effective therapy and increased crude mortality [ 13].
It is an aggressive protocol but, as demonstrated by Kumar and colleagues [ 55], time to the initiation of effective antimicrobial therapy is the single greatest predictor of survival in patients who develop septic shock.
Women often need prompt initiation of effective contraception.
CONCLUSIONS: The risk of stroke in IE falls dramatically after the initiation of effective antimicrobial therapy.
In bivariable analysis, delay in initiation of effective therapy for >72 h after diagnosis of BSI was associated with death (P = 0.03).
The key elements of TB control programmes are early diagnosis and prompt initiation of effective chemotherapy.
A more rapid method is needed to allow timely diagnosis and initiation of effective treatment.
General hospitals can provide a base for the initiation of effective smoking cessation interventions [ 25- 28].
(The Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy Trial [STABILITY]; NCT00799903).
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