Clinical Characteristics, Empirical Antibiotic Appropriateness, and Outcomes of Gram-Positive Versus Gram-Negative Bacteremia in Emergency Department Patients with Sepsis.

In bacteremic sepsis, gram-positive bacteremia was associated with worse observed outcomes and substantially more frequent inappropriate empirical antibiotic therapy than gram-negative bacteremia.

gram-positive bacteremia should be interpreted less as a standalone microbiologic determinant of mortality and more as a marker of a clinically vulnerable and management-challenging profile.

Our findings point to a modifiable diagnostic-treatment gap in early emergency department recognition and empirical antibiotic selection.