Restrictive antibiotic policies are appropriate in intensive care units

Paterson, David L. (2003) Restrictive antibiotic policies are appropriate in intensive care units. Critical Care Medicine, 31 Supp. 1: S25-S28. doi:10.1097/01.CCM.0000045029.58984.94

Author Paterson, David L.
Title Restrictive antibiotic policies are appropriate in intensive care units
Journal name Critical Care Medicine   Check publisher's open access policy
ISSN 0090-3493
Publication date 2003-01-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/01.CCM.0000045029.58984.94
Open Access Status Not Open Access
Volume 31
Issue Supp. 1
Start page S25
End page S28
Total pages 4
Editor Joseph Parrillo
J. Christopher Farmer
Place of publication New York, U.S.A.
Publisher Lippincott Williams & Wilkins
Language eng
Subject 1103 Clinical Sciences
Abstract Antibiotic use will always be an important part of medical practice in the intensive care unit. Antibiotic resistance increases the chance that empirical therapy will be inadequate to cover the organisms implicated in any particular infection. Therefore, strategies that can allow for optimal empirical antibiotic choice, while at the same time minimizing emergence of antibiotic resistance, are particularly important. In many situations, such strategies require some external stewardship of antibiotic use to be maximally effective. Antibiotic stewardship programs may take the form of management teams comprising infectious disease physicians and pharmacists. These clinicians work in concert with critical care specialists in choosing optimal empirical regimens and in streamlining therapy once culture results are available. Alternatively, computer-based clinical support systems have been developed that can guide physicians to utilize optimal antibiotic choices. External stewardship of antibiotic use may be particularly necessary in circumstances of increased antibiotic resistance, especially exhibited by Gram-negative bacilli. A number of examples exist in which antibiotic control programs can work when traditional infection control programs have failed. Mutation of organisms to produce antibiotic resistance is undoubtedly going to outstrip availability of new antibiotics in the near future. Antibiotic stewardship in concert with improved diagnostic methods may be our only hope in preventing endemic panresistant organisms. (Crit Care Med 2003; 31[Suppl.]:S25–S28)
Keyword Antibiotic resistance
Intensive care unit
Infection control
Q-Index Code C1

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Faculty of Health and Behavioural Sciences -- Publications
Excellence in Research Australia (ERA) - Collection
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Created: Wed, 06 Jan 2010, 19:56:23 EST by Ms Susana Macanawai on behalf of Faculty Of Health Sciences