Data collection
K.C.S., S.C.L., and S.M.T. retrospectively extracted data from medical records. Because all PBFM steps were recorded in the ICU computer, adherence could be accurately determined. Diagnosis was taken as the main diagnosis recorded in the ICU admission notes. The predominant cause of shock was derived from documented clinical judgment at the point of ICU admission. Glasgow Coma Scale scores were taken as the worst score before any sedation or intubation. Antibiotic therapy was considered discordant if blood or urine cultures were resistant to all of the empiric choices.