Appropriateness is Critical

Marta Ulldemolins, Xavier Nuvials, Mercedes Palomar, Joan R. Masclans, Jordi Rello

    Research output: Contribution to journalReview articleResearchpeer-review

    13 Citations (Scopus)

    Abstract

    Inappropriate empirical antibiotic therapy for severe infections in the intensive care unit is a modifiable prognostic factor that has a great effect on patient outcome and health care resources. Inappropriate treatment is usually associated with microorganisms resistant to the common antibiotics, which must be empirically targeted when risk factors are present. Previous antibiotic exposure, prolonged length of hospital stay, admission category, local susceptibilities, colonization pressure, and the presence of invasive devices increase the likelihood of infection by resistant pathogens. Consideration of issues beyond in vitro susceptibility, such as antibiotic physicochemistry, tissue penetration, and pharmacokinetic/pharmacodynamic-driven dosing, is mandatory for the optimization of antibiotic use. © 2011 Elsevier Inc.
    Original languageEnglish
    Pages (from-to)35-51
    JournalCritical Care Clinics
    Volume27
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2011

    Keywords

    • Adequate
    • Bloodstream infection
    • Critically ill patient
    • Empirical antibiotics
    • Optimal
    • Pneumonia
    • Susceptibility

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