In this VETgirl podcast, Dr. Lisa Powell, DACVECC reviews a study out of Tufts University assessing the time of antimicrobial administration in the treatment of septic peritonitis and overall survival. Does it matter when you reach for a vial of antibiotics in your emergent or critically ill patients? The goals of this study were to determine whether creation and implementation of a canine abdominal sepsis protocol decreased time to antimicrobial administration in dogs with septic peritonitis. What did this study find? Overall, the median time from diagnosis of septic peritonitis to antimicrobial administration was 6 hours in the preprotocol group (PRE), and 1 hour in the postprotocol group (POST) (P = 0.001). 25% of the culture and sensitivity results were negative in the PRE versus the POST group (17.6%). 15% of the time, the wrong empirical antimicrobial was selected in the PRE group (compared to 8.8% of the time in the POST group). Overall, the survival to discharge was 60% in the PRE and 70% in the POST, but this wasn't statistically significant (P = 0.425). That said, the development of an emergency department antimicrobial protocol did apparently decrease thetime to antimicrobial administration following identification of septic peritonitis in dogs. VETgirl's take from this? Implement antibiotics soon, but ideally culture first. Do a simple Gram stain in your clinic to make sure you are choosing the correct empirical antimicrobials to use! References: 1. Abelson AL, Buckley GJ, Rozanski EA. Positive impact of an emergency department protocol on time to antimicrobial administration in dogs with septic peritonitis. J Vet Emerg Crit Care 2013;23(5):551-556