title: How to break the vicious circle of antibiotic resistances?
abstract: OBJECTIVE
  To review the new findings on the use of antibiotics in the ICU patients.
  
  
  RESULTS
  Although there are several lines of evidence for a prompt use of antibiotics in life-threatening infections, restricting the use of antibiotics should remain the common rule. In order to reduce the emergence of multiresistant bacteria, several approaches have been tested: knowledge of local ecology, choice of the best dose of antibiotics based on their pharmacokinetic and pharmacodynamic properties, de-escalation after results of cultures, and shortening the duration of treatment. An integrative strategy including all these approaches could be associated with a reduced incidence of multiresistant bacteria.
  
  
  CONCLUSIONS
  Good evidence suggests that a strategy aiming at reducing the prolonged use of broad-spectrum antibiotics is the only mean to reduce the emergence of multiresistant bacteria.
authors.affiliation: Service d'anesthésie et de réanimation, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Université de la Méditerranée, Marseille, France. marc.leone@ap-hm.fr
authors.forename: Marc
authors.initials: M
authors.lastname: Leone
authors.forename: Claude
authors.initials: C
authors.lastname: Martin
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D006801:Humans; D007362:Intensive Care Units
chemical_list: D000900:Anti-Bacterial Agents