Figure 1.

Histogram of the distribution of time to first IV antibiotics (larger gray bars), measured from ED arrival, in 3 mutually exclusive cohorts of patients with increasing severity of presentation: (A) suspected infection, defined by blood culture drawn and IV antibiotics administered within 24 hours; (B) suspected sepsis, which also requires lab evidence of organ dysfunction or mechanical ventilation within 12 hours; and (C) suspected septic shock, which also requires evidence of hypoperfusion, specifically SBP <90 mmHg or lactate >4.0 mmol/L, within 12 hours. Each bar represents an hourly interval starting from 0. The count of patients in each interval experiencing in-hospital mortality or discharge to hospice is overlaid as a smaller red bar. The proportion of patients receiving antibiotics before 6 hours is indicated next to the vertical lines. Abbreviations: ED, emergency department; hrs, hours; IV, intravenous; SBP, systolic blood pressure.