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Obtaining blood cultures during antibiotic therapy is associated with a significant loss of pathogen detection. This strongly emphasizes the current recommendation to obtain blood cultures before antibiotic administration in patients with sepsis.

for the German Study Group Competence Network Sepsis (SepNet) I NAPPROPRIATE INITIAL ANTIMICRObial therapy (defined as an antimicrobial regimen that lacks in vitro activity against the isolated organisms responsible for the infection) is associated with increased mortality Author Affiliations and a list of the German Study Group Competence Network Sepsis investigators appear at the end of this article.

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Delay in antimicrobial therapy and source control was associated with increased mortality but the multifaceted approach was unable to change time to antimicrobial therapy in this setting and did not affect survival.