[Antibiotic strategy in infections caused by resistant strains during intensive care].
The choice of antibiotherapy during infections occurring in intensive care units is rather difficult. According to clinical severity criteria, and high percentage of resistant strains, it could be easier to prescribe wide spectrum newer antibiotics, specially when they are not susceptible to bacterial resistance mechanism. Such antibiotics large use can trigger infection or colonization nosocomial epidemics. These infections are caused by bacterias resistant to the antibiotic prescribed, selected mutant of plasmidic resistant bacteria, or strains with other resistant mechanism. These problems of nosocomial infections have to be daily considered in intensive care units where are concentrated patients at high risk and a great number of contamination conditions. In intensive care practice, when occurs a nosocomial infection, we need efficacy. One can use the last antibiotic, with a wide spectrum, to give the patient the best chance. But some do not approve this strategy which could enhance the risk of new more resistant strains epidemics in hospital. The antibiotic choice has to consider each clinical situation, the epidemiological conditions in the hospital, in the unit, and the advantage to risk ratio reported to economical conditions.
Veyssier
P
P
Service de médecine interne et de réanimation, Centre hospitalier de Compiègne.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D002985:Clinical Protocols; D003422:Critical Care; D003428:Cross Infection / Q000188:drug therapy; D004352:Drug Resistance, Microbial; D006801:Humans
D000900:Anti-Bacterial Agents
Stratégie antibiotique dans les infections à germes résistants apparues en réanimation.