# Association of patient characteristics and antibiotic timing with the development of acute respiratory failure in hospital-acquired sepsis

> **NIH NIH F32** · UNIVERSITY OF PENNSYLVANIA · 2021 · $78,866

## Abstract

Project Summary
Acute respiratory failure and sepsis are the leading causes of critical illness and death in hospitalized patients.
Patients who become septic during hospitalization are at high risk of developing acute respiratory failure: up to
50% require mechanical ventilation. Sepsis patients with lung injury and respiratory failure have more than
double the mortality of those without respiratory failure, but little is known about how to prevent this important
complication in hospital-acquired sepsis. Guidelines recommend initiating antibiotics within one hour for all
septic patients, but these recommendations rely on evidence primarily from patients with community-acquired
sepsis, a population known to differ in characteristics, risks, and outcomes from patients with hospital-acquired
sepsis. Furthermore, patients with hospital-acquired sepsis have well-documented delays in sepsis care and
infrequently achieve quality targets for antibiotic timing. Critical knowledge gaps exist regarding determinants
and implications of antibiotic timing among patients with hospital-acquired sepsis, limiting our ability to prevent
the development of acute respiratory failure and other adverse outcomes in this high-risk population. The goals
of this study are to identify the characteristics of patients’ clinical presentation associated with antibiotic timing
in hospital-acquired sepsis, and to evaluate the role of antibiotic timing in reducing the risk of respiratory
failure. First, using a retrospective cohort of approximately 1,800 inpatients with hospital-acquired sepsis, we
will test the association of patient-level clinical factors at time of sepsis onset with time to antibiotic initiation.
Second, we will test the association of antibiotic timing with the development of acute respiratory failure, using
applied regression and instrumental variable methods. This project is supported by the Palliative and
Advanced Illness Research (PAIR) Center of the University of Pennsylvania, which has an outstanding track
record of supporting and advancing the careers of health services researchers in training. The candidate will
be intensively mentored by a team with expertise in acute respiratory failure, sepsis, resource strain, and
causal inference methods. Experiential training through this project will be complemented with coursework in
applied regression and time-to-event analysis. Findings from this work will directly inform the development of
an application for a K23 Mentored Career Development Award that aims to identify important sepsis clinical
subgroups in order to improve the timeliness of sepsis care and our ability to prevent progression to respiratory
failure.

## Key facts

- **NIH application ID:** 10313769
- **Project number:** 1F32HL160037-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Jennifer Claire Ginestra
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $78,866
- **Award type:** 1
- **Project period:** 2022-01-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10313769

## Citation

> US National Institutes of Health, RePORTER application 10313769, Association of patient characteristics and antibiotic timing with the development of acute respiratory failure in hospital-acquired sepsis (1F32HL160037-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10313769. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*