Abstract
The role of antibiotic pressure in the selection of antibiotic-resistant bacteria is still under debate in the scientific community and often confounded by scarce data on antibiotic usage. Several studies demonstrated that prior antibiotic exposure is likely to increase patient’s colonization and infection by antimicrobial-resistant bacteria. Of even more concern is the significant mortality associated with these infections, in particular in critically ill patients. Therefore, the control of antibiotic usage in intensive care units (ICUs) is of paramount importance. Antibiotic stewardship programmes (ASP) have been demonstrated to represent a useful intervention to reduce the inappropriate antibiotic usage in hospitalized patients. A few trials were performed in ICU population with positive results. The major risk we foresee for the implementation of ASP for ICU patients is the lack of consideration of local ecology and strict quality indicators. The development of new pattern of antimicrobial resistance might be ascribed to an inappropriate ASP. European networks to define best strategies and antibiotic-care bundles need to be supported at national and international level. To optimize antibiotic use in the ICU and to fight against the spread of resistance, it is extremely important to adopt a multifaceted approach including ASP.
Keywords: Antibiotic stewardship, ICU, antibiotic resistance, inappropriate antibiotic, patient, ’, s colonization and infection, antimicrobial resistance, vancomycin-resistant, fluoroquinolone-susceptible, anaerobic-active antibiotics, ciprofloxacin, gastrointestinal tract, gram-negative bacteria, fluoroquinolones usage, antimicrobial therapy, anti-pseudomonal, colonisation and infections
Infectious Disorders - Drug Targets
Title: How Could We Reduce Antibiotic Use in Critically Ill Patients?
Volume: 11 Issue: 4
Author(s): Giulia De Angelis, Giovanni Restuccia, Roberto Cauda and Evelina Tacconelli
Affiliation:
Keywords: Antibiotic stewardship, ICU, antibiotic resistance, inappropriate antibiotic, patient, ’, s colonization and infection, antimicrobial resistance, vancomycin-resistant, fluoroquinolone-susceptible, anaerobic-active antibiotics, ciprofloxacin, gastrointestinal tract, gram-negative bacteria, fluoroquinolones usage, antimicrobial therapy, anti-pseudomonal, colonisation and infections
Abstract: The role of antibiotic pressure in the selection of antibiotic-resistant bacteria is still under debate in the scientific community and often confounded by scarce data on antibiotic usage. Several studies demonstrated that prior antibiotic exposure is likely to increase patient’s colonization and infection by antimicrobial-resistant bacteria. Of even more concern is the significant mortality associated with these infections, in particular in critically ill patients. Therefore, the control of antibiotic usage in intensive care units (ICUs) is of paramount importance. Antibiotic stewardship programmes (ASP) have been demonstrated to represent a useful intervention to reduce the inappropriate antibiotic usage in hospitalized patients. A few trials were performed in ICU population with positive results. The major risk we foresee for the implementation of ASP for ICU patients is the lack of consideration of local ecology and strict quality indicators. The development of new pattern of antimicrobial resistance might be ascribed to an inappropriate ASP. European networks to define best strategies and antibiotic-care bundles need to be supported at national and international level. To optimize antibiotic use in the ICU and to fight against the spread of resistance, it is extremely important to adopt a multifaceted approach including ASP.
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Cite this article as:
De Angelis Giulia, Restuccia Giovanni, Cauda Roberto and Tacconelli Evelina, How Could We Reduce Antibiotic Use in Critically Ill Patients?, Infectious Disorders - Drug Targets 2011; 11 (4) . https://dx.doi.org/10.2174/187152611796504791
DOI https://dx.doi.org/10.2174/187152611796504791 |
Print ISSN 1871-5265 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3989 |
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