Strategies to prevent antimicrobial resistance in the intensive care unit.
OBJECTIVE
To assemble the available clinical data for the prevention of antimicrobial resistance into practical recommendations for clinicians.


METHODS
A Medline database and references from identified articles were employed to perform a literature search relating to the prevention of antimicrobial resistance.


CONCLUSIONS
Antimicrobial resistance has emerged as an important determinant of mortality for patients in the intensive care unit. This is largely due to the increasing presence of pathogenic microorganisms with resistance to existing antimicrobial agents, resulting in the administration of inappropriate treatment. Effective strategies for the prevention of antimicrobial resistance within intensive care units are available and should be aggressively implemented. These strategies can be divided into nonpharmacologic infection control strategies (e.g., routine hand hygiene, implementation of infection-specific prevention protocols) and antibiotic management strategies (e.g., shorter courses of appropriate antibiotic treatment, narrowing of antimicrobial spectrum based on culture results). Increasing current efforts aimed at the prevention of antimicrobial resistance is especially important given the limited availability of new antimicrobial drug classes for the foreseeable future.
Kollef
Marin H
MH
Department of Internal Medicine, Pulmonary and Critical Care Division, Washington University School of Medicine, St. Louis, MO 63110, USA. mkollerf@im.wustl.edu
Micek
Scott T
ST
D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004351:Drug Resistance; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units; D017410:Practice Guidelines as Topic; D018570:Risk Assessment
D000900:Anti-Bacterial Agents