Purpose: 
In sepsis, early antibiotic treatment is vital. In the physician-manned prehospital mobile emergency care unit (MECU) in Odense, Denmark, antibiotics are part of the treatment offered to patients with suspected severe infections. This provides the patients with early administration of antibiotics preceded by blood cultures. 
We conducted a study of the prehospital recognition of sepsis or severe infections and prehospital blood culturing done by the MECU. We evaluated the accuracy of the prehospital diagnoses and the usefulness of the prehospital blood cultures. 
Methods and materials:
Inclusion criteria: In all patients receiving prehospital antibiotics during November 2013 to October 2018, we registered vital parameters, prehospital diagnoses, and the microorganisms detected in the prehospital blood cultures. The findings in the blood cultures were assessed for true infection or contamination.
The patients´ prehospital diagnoses were compared with the diagnoses assigned following complete in-hospital work-up and assessed for the rationale for treatment. 
Results: 
117 patients were included, 58.1% males. The median time from first prehospital contact to arrival at the emergency department was 36 min. The findings of vital parameters outside the normal range included: Temperature (median 38,6), respiratory rate (median 25.2 breaths per minute), heart rate (median 110 beats per minute), Glasgow Coma Score (median 12), and lactate (median 3.6 mmol/L).
Blood cultures were drawn and analyzed in 108 patients.  
A causative pathogen of sepsis was found in 33.3% of all patients. 6.8% of the patients had positive blood cultures that were regarded as being contaminated. 
68 patients were diagnosed prehospitally as having sepsis. 38.2% of these diagnoses were confirmed in-hospitally with blood cultures or other microbiological samples. 
Conclusions:
Administration of prehospital antibiotics by a MECU is feasible with an acceptable accuracy of diagnosis, a high degree of positive blood cultures and an acceptably low degree of accidental contamination of blood cultures.

8 - Physician Administered Antibiotics in Severe Infections in a Prehospital Setting