[Antibiotic strategies in the treatment of infection in critically ill patients].
Inappropriate antimicrobial therapy of pneumonia, severe sepsis and bacteraemia is associated with high mortality. Adjustment of insufficient initial antibiotics after susceptibility testing does not reduce mortality. Guidelines on critically ill patients should focus on antibiograms for each intensive care unit to ensure full coverage of initial therapy with a broad-spectrum antibiotic with high tissue penetration, minimal organ toxicity and low risk of resistance development. Early reassessment and withdrawal of antibiotics, if not indicated, are important elements in reducing antibiotic resistance. The initial broad-spectrum should be narrowed according to bacterial susceptibility data. This evidence-based intervention ensures appropriate antimicrobial treatment to critically ill patients to improve outcome and reduction of the use of broad-spectrum antibiotics.
Schierbeck
Jens
J
Odense Universitetshospital, Anaestesiologisk-intensiv Afdeling V, Odense C. jens.schierbeck@ouh.fyns-amt.dk
Kolmos
Hans Jørn J
HJ
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D024881:Drug Resistance, Bacterial; D019317:Evidence-Based Medicine; D006801:Humans; D008826:Microbial Sensitivity Tests; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D018805:Sepsis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents