title: How to treat infections in a surgical intensive care unit.
abstract: The management of infections in surgical intensive care unit patients poses specific challenges. Although the overall approach to the patient is no different from other patients, diagnosis is often problematic. As in other infections, multidrug resistance is increasingly described, and changes in pharmacokinetics may require different dosing strategies. Also the need for source control adds a level of complexity to the management of the patient. Whereas source control was a purely surgical issue before, percutaneous drainage has emerged as an important alternative. Appropriate timing of source control often remains difficult to determine, but in most severe infections source control should not be delayed. But also the need for a multidisciplinary approach can make the decision making difficult. New concepts such as dedicated source control teams may further assist in selecting the most appropriate treatment strategy and further improve outcome of surgical severe sepsis patients.
authors.affiliation: Department of Critical Care Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium. Jan.DeWaele@UGent.be.
authors.forename: Jan
authors.initials: J
authors.lastname: De Waele
authors.forename: Liesbet
authors.initials: L
authors.lastname: De Bus
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003422:Critical Care; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D004322:Drainage; D006801:Humans; D007362:Intensive Care Units; D011183:Postoperative Complications / Q000188:drug therapy* / Q000517:prevention & control; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents