Study: Overuse of Broad-Spectrum Antibiotics in Suspected Sepsis Patients

A study published April 15 in the journal Clinical Infectious Diseases, entitled “Frequency of Antibiotic Overtreatment and Associated Harms in Patients Presenting With Suspected Sepsis to the Emergency Department: A Retrospective Cohort Study” raises concerns about the widespread use of broad-spectrum antibiotics in patients suspected of having sepsis, suggesting a significant number may be overtreated.

Researchers reviewed the records of 600 adults treated in emergency departments at seven U.S. hospitals between 2019 and 2022. They found that 31.5% of patients “most likely did not have a bacterial infection,” yet still received broad antibiotics targeting MRSA and Pseudomonas.

Even among those with confirmed or probable infections, “four in five were treated with regimens that were broader than necessary in retrospect,” the study reported. Within 90 days, 17.3% of all patients developed potential antibiotic-related complications, including resistant infections.

The study also revealed a mortality difference: patients with less likely or no bacterial infection had nearly double the death rate (9.0%) compared to those with confirmed or probable infection (4.9%), with an adjusted odds ratio of 2.25.

The authors conclude that while timely antibiotic treatment for sepsis remains critical, “careful stewardship is needed to minimize unnecessary exposure to broad-spectrum agents.”