title: Fighting antibiotic resistance in the intensive care unit using antibiotics.
abstract: Antibiotic resistance is a global and increasing problem that is not counterbalanced by the development of new therapeutic agents. The prevalence of antibiotic resistance is especially high in intensive care units with frequently reported outbreaks of multidrug-resistant organisms. In addition to classical infection prevention protocols and surveillance programs, counterintuitive interventions, such as selective decontamination with antibiotics and antibiotic rotation have been applied and investigated to control the emergence of antibiotic resistance. This review provides an overview of selective oropharyngeal and digestive tract decontamination, decolonization of methicillin-resistant Staphylococcus aureus and antibiotic rotation as strategies to modulate antibiotic resistance in the intensive care unit.
authors: Julius Center for Epidemiology of Infectious Disease, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Nienke L
authors: NL
authors: Plantinga
authors: Bastiaan H J
authors: BH
authors: Wittekamp
authors: Pleun J
authors: PJ
authors: van Duijn
authors: Marc J M
authors: MJ
authors: Bonten
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D003666:Decontamination / Q000379:methods; D024881:Drug Resistance, Bacterial; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D007362:Intensive Care Units; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D009960:Oropharynx / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic resistance; antibiotic rotation; cycling; decolonization; intensive care unit; mixing; multidrug-resistant bacteria; selective decontamination