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Background: Bamlanivimab and casirivimab/imdevimab are recombinant neutralizing monoclonal antibodies that decrease viral load in patients with coronavirus disease 2019 (COVID-19) and can decrease hospitalizations. Few data exist comparing these two therapies., Objective: Our aim was to compare the efficacy and safety of bamlanivimab and casirivimab/imdevimab in emergency department (ED) patients with COVID-19 who met criteria for monoclonal antibody therapy., Methods: We performed a single-center, open-label, prospective study in adult ED patients with confirmed COVID-19 and high-risk features for hospitalization. Enrolled patients received bamlanivimab or casirivimab/imdevimab, depending on the day of the week that they arrived. We observed patients for post-infusion-related reactions and contacted them on days 5, 10, and 30. The primary outcome was the number of hospitalizations through day 30. In addition, we compared groups with regard to return visits to the ED, symptom improvement, antibody-induced adverse events, and deaths., Results: Between December 17, 2020 and January 17, 2021, 321 patients completed the study. We found no statistically significant difference in the rate of subsequent hospitalization between groups (bamlanivimab: n = 18 of 201 [8.9%] and casirivimab/imdevimab: n = 13 of 120 [10.8%]; p = 0.57). In addition, we found no statistically significant differences between groups regarding return visits to the ED or symptom improvement. One patient had a possible adverse reaction to the treatment, and 1 patient died. Both of these events occurred in the bamlanivimab group., Conclusions: We found no statistically significant differences in rates of subsequent hospitalization or other outcomes for ED patients with COVID-19 when they received bamlanivimab as opposed to casirivimab/imdevimab. Adverse events were rare in both groups., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Some experts recommend using a 1-h sepsis bundle, but clinical data supporting this strategy are lacking., Objectives: We aimed to determine the rate of, and clinical predictors for, bacteremia for patients undergoing a 1-h sepsis bundle, and to determine the percentage of "code sepsis" patients who are ultimately diagnosed with sepsis or a bacterial infection., Methods: This retrospective chart review evaluated code sepsis patients from three emergency departments (EDs) that utilize a 1-h sepsis bundle. The primary outcome was the rate of true-positive blood cultures. Secondarily, we analyzed various clinical factors using logistic regression analysis to determine which are associated with bacteremia., Results: Of the 544 code sepsis patients analyzed, 33.8% (95% confidence interval [CI] 29.9-38.0%) were ultimately diagnosed with sepsis, and 54.6% (95% CI 50.3-58.8%) were diagnosed with a bacterial infection. Exactly 7.0% (95% CI 5.0-9.5%) of the blood cultures performed were true positives. On multivariate logistic regression analysis, temperature > 38°C (100.4°F) or < 36°C (96.8°F), lactate > 4 mmol/L, and indwelling line/device were found to be positively associated with true-positive blood cultures., Conclusion: In a group of code sepsis patients from facilities that use a 1-h sepsis bundle, the majority were ultimately not diagnosed with sepsis, and nearly half did not have a bacterial infection. A small minority of patients had bacteremia. Restricting blood culture ordering in patients with possible sepsis to only those who have increased risk for bacteremia could lead to a more judicious use of blood cultures., (Copyright © 2020 Elsevier Inc. All rights reserved.)