Impact of choice of Antibiotics on Antibiotic Resistance, Morbidity and Mortality in Critically Ill Patients
Ahmed Anas Mohamed Salama;
Abstract
The intensive care unit (ICU) is a place where patients with complex medical problems are crowded into a small area. The acute nature of critically ill patients necessitate the use of broad-spectrum antibiotics frequently (Sarin et al., 2015).
Antibiotic therapy must be initiated immediately in febrile patients with neutropenia, especially when criteria of severe sepsis are met. The antibiotics used for first-line therapy must be active against the most likely pathogens, as estimated based on the suspected source of infection. Suspicion of catheter-related infections or new pulmonary infiltrates are other indications of intravenous antibiotics administration.
Persistence of fever with clinical deterioration or infectious disease progression should be distinguished from persistence of fever in a clinically stable patient, For clinically stable patients with persistent fever, there is no published evidence to support a change in the antibiotic regimen.
Although the ICU remains at the center of the crisis of antimicrobial resistance in hospitalized patients. So The best way to reduce the emergence of resistant strains, especially in ICUs, is the rational use of antimicrobial strategies.
De-escalation on the basis of microbiology results may limit the development of antimicrobial resistance.
Continuous infusions of Beta-lactam antibiotics have been employed in an attempt to maximize the time that free drug concentrations exceed the bacterial MIC, Several studies have shown beneficial outcomes associated with continuous infusion piperacillin–tazobactam.
Several new drugs for severe infections have been approved within the past decade, but the pipeline of novel drugs to meet the challenge of MDR gram-negative pathogens remains limited.
References
Antibiotic therapy must be initiated immediately in febrile patients with neutropenia, especially when criteria of severe sepsis are met. The antibiotics used for first-line therapy must be active against the most likely pathogens, as estimated based on the suspected source of infection. Suspicion of catheter-related infections or new pulmonary infiltrates are other indications of intravenous antibiotics administration.
Persistence of fever with clinical deterioration or infectious disease progression should be distinguished from persistence of fever in a clinically stable patient, For clinically stable patients with persistent fever, there is no published evidence to support a change in the antibiotic regimen.
Although the ICU remains at the center of the crisis of antimicrobial resistance in hospitalized patients. So The best way to reduce the emergence of resistant strains, especially in ICUs, is the rational use of antimicrobial strategies.
De-escalation on the basis of microbiology results may limit the development of antimicrobial resistance.
Continuous infusions of Beta-lactam antibiotics have been employed in an attempt to maximize the time that free drug concentrations exceed the bacterial MIC, Several studies have shown beneficial outcomes associated with continuous infusion piperacillin–tazobactam.
Several new drugs for severe infections have been approved within the past decade, but the pipeline of novel drugs to meet the challenge of MDR gram-negative pathogens remains limited.
References
Other data
| Title | Impact of choice of Antibiotics on Antibiotic Resistance, Morbidity and Mortality in Critically Ill Patients | Other Titles | تأثيراختيار المضادات الحيويه على مقاومه المضادات الحيويه و معدلات الوفيات والمضاعفات فى مرضى الرعايه المركزة | Authors | Ahmed Anas Mohamed Salama | Issue Date | 2017 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.