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{Moral: Not sure what the heck I did to get it to work last time } “Anyone with a printer. for optimal antibiotic use. However, an early carbapenem use is often a marker of severe infection \[[@CR37]\]. Even if not mentioned in the results of the present study, our results show that hospital mortality was associated with elevated CRP concentrations at presentation, but also with an increased PSI risk score at presentation. Surprisingly, the patient is not mentioned in the daily clinical routine. We conclude that the patient was not ill enough to be given the chance to get a timely diagnosis and therapy. This could have led to poorer outcomes. Further studies are needed to explore what the optimal moment of therapy administration is. The last 3 days of the hospital stay seem to be too late. Limitations {#Sec5} ———– Our study suffers from some limitations. First, this retrospective study uses data from a single tertiary care center. Further studies with larger cohorts are needed to confirm these results. Second, the study is monocentric with all the associated bias. Future studies should include multiple centers and better record the moment of administration of antibiotic therapy and include timing as a covariate in the analysis. Conclusion {#Sec6} ========== Hospital mortality is influenced by a patient’s state of health on admission. Despite the fact that patients with mild systemic inflammatory response on admission had a lower mortality, most patients presented at the hospital in a state of severe systemic inflammation. A longer duration of symptoms and lower temperatures appeared to be associated with higher mortality. These factors were also identified as protective factors in the multivariate analysis. These results are not fully understood. Although we are not certain of the patients who receive antibiotics, this study clarifies the findings from previous studies. A patient’s current status can be a valuable parameter of mortality risk. As the results of a single center study, our results need to be confirmed by future studies. This study aims to support physicians in their decision-making. This is why treatment within the first 48 h after admission seems to be the right moment to treat a patient. Patients who are unwell should not be treated until the moment when clinical improvement is achieved. Otherwise, a wait-and-see approach could be a risk factor for the patient. Physicians should be aware that the detection of mild systemic inflammation at admission as a clinical presentation could be used as an early warning sign that an ICU admission could be beneficial c6a93da74d
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