Appropriateness is Critical

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

doi:10.1016/j.ccc.2010.09.007

Appropriateness is Critical

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

Research output: Contribution to journal › Review article › Research › peer-review

22 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 language	English
Pages (from-to)	35-51
Journal	Critical Care Clinics
Volume	27
Issue number	1
DOIs	https://doi.org/10.1016/j.ccc.2010.09.007
Publication status	Published - 1 Jan 2011

Keywords

Adequate
Bloodstream infection
Critically ill patient
Empirical antibiotics
Optimal
Pneumonia
Susceptibility

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10.1016/j.ccc.2010.09.007

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title = "Appropriateness is Critical",

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. {\textcopyright} 2011 Elsevier Inc.",

keywords = "Adequate, Bloodstream infection, Critically ill patient, Empirical antibiotics, Optimal, Pneumonia, Susceptibility",

author = "Marta Ulldemolins and Xavier Nuvials and Mercedes Palomar and Masclans, {Joan R.} and Jordi Rello",

year = "2011",

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T1 - Appropriateness is Critical

AU - Ulldemolins, Marta

AU - Nuvials, Xavier

AU - Palomar, Mercedes

AU - Masclans, Joan R.

AU - Rello, Jordi

PY - 2011/1/1

Y1 - 2011/1/1

N2 - 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.

AB - 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.

KW - Adequate

KW - Bloodstream infection

KW - Critically ill patient

KW - Empirical antibiotics

KW - Optimal

KW - Pneumonia

KW - Susceptibility

U2 - 10.1016/j.ccc.2010.09.007

DO - 10.1016/j.ccc.2010.09.007

M3 - Review article

SN - 0749-0704

VL - 27

SP - 35

EP - 51

JO - Critical Care Clinics

JF - Critical Care Clinics

IS - 1

ER -

Appropriateness is Critical

Abstract

Keywords

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