title: Strategies for appropriate antibiotic use in intensive care unit.
abstract: The comsumption of antibiotics is high, mainly in intensive care units. Unfortunately, most are inappropriately used leading to increased multi-resistant bacteria. It is well known that initial empirical therapy with broad-spectrum antibiotics reduce mortality rates. However the prolonged and irrational use of antimicrobials may also increase the risk of toxicity, drug interactions and diarrhea due to Clostridium difficile. Some strategies to rational use of antimicrobial agents include avoiding colonization treatment, de-escalation, monitoring serum levels of the agents, appropriate duration of therapy and use of biological markers. This review discusses the effectiveness of these strategies, the importance of microbiology knowledge, considering there are agents resistant to Staphylococcus aureus and Klebsiella pneumoniae, and reducing antibiotic use and bacterial resistance, with no impact on mortality.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Camila Delfino Ribeiro da
authors.initials: CD
authors.lastname: Silva
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Moacyr
authors.initials: M
authors.lastname: Silva Júnior
mesh_terms: D000900:Anti-Bacterial Agents / Q000592:standards* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy* / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000592:standards; D006801:Humans; D007362:Intensive Care Units
chemical_list: D000900:Anti-Bacterial Agents