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Sepsis Hour-1 Bundle — RACP Adult Medicine MCQ

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EasyInfectious DiseasesSepsis Hour-1 BundleRACP Adult Medicine

A 55-year-old man presents with suspected sepsis (fever 39.5°C, HR 120, BP 85/50, lactate 4.5 mmol/L, WCC 22 × 10⁹/L). He has a productive cough and RLL consolidation on CXR. Which component of the Surviving Sepsis hour-1 bundle is the highest priority?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — IV antibiotics within 1 hour

While all bundle components should be initiated within 1 hour, IV antibiotics are the single highest-impact intervention. Each hour of delay in antibiotics increases mortality by ~7.6%. Blood cultures should ideally be obtained before antibiotics but should not delay antibiotic administration. The full hour-1 bundle: measure lactate, blood cultures, IV antibiotics, 30 mL/kg crystalloid if hypotensive.

Reference: Surviving Sepsis Campaign 2021; eTG Antibiotic 2025 – Sepsis