Background: Timely antimicrobial therapy is central to pediatric sepsis care. Associations between treatment timing and outcomes vary with illness severity, recognition processes, and the definition of time zero.

Objective: To describe antibiotic administration timing after documented sepsis recognition among children with sepsis, using the 330-minute threshold available in the cohort summary.

Methods: This retrospective descriptive cohort study included 377 children presenting to the emergency department of South Al-Qunfudhah Hospital, Saudi Arabia, from 21 May 2021 through 1 September 2026. The aggregate data classified first antibiotic administration as <330 or ≥330 minutes after documented sepsis recognition. Counts, percentages, and Wilson 95% confidence intervals (CIs) were calculated. Clinical outcomes and patient-level covariates were unavailable.

Results: Antibiotics were administered before 330 minutes in 370 children (98.14%; 95% CI, 96.22%-99.10%) and at or after 330 minutes in 7 children (1.86%; 95% CI, 0.90%-3.78%).

Conclusion: Antibiotic administration at or after 330 minutes was uncommon. These descriptive findings do not establish associations with clinical outcomes, and the threshold should not be interpreted as a recommended treatment target.

Keywords: Pediatric Sepsis; Antibiotic Timing; Emergency Department; Saudi Arabia; Retrospective Cohort; Antimicrobial Therapy

Abbreviations

CI: Confidence Interval; Cis: Confidence Intervals; N: Total Cohort Size; n: Subgroup Size; REC: Research Ethics Committee

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