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Antimicrobial Stewardship in the ICU.
Murphy, Claire V; Reed, Erica E; Herman, Derrick D; Magrum, BrookeAnne; Beatty, Julia J; Stevenson, Kurt B.
Afiliación
  • Murphy CV; Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • Reed EE; Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • Herman DD; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • Magrum B; Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • Beatty JJ; Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio.
  • Stevenson KB; Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Semin Respir Crit Care Med ; 43(1): 131-140, 2022 02.
Article en En | MEDLINE | ID: mdl-35172363
ABSTRACT
Increasing rates of infection and multidrug-resistant pathogens, along with a high use of antimicrobial therapy, make the intensive care unit (ICU) an ideal setting for implementing and supporting antimicrobial stewardship efforts. Overuse of antimicrobial agents is common in the ICU, as practitioners are challenged daily with achieving early, appropriate empiric antimicrobial therapy to improve patient outcomes. While early antimicrobial stewardship programs focused on the financial implications of antimicrobial overuse, current goals of stewardship programs align closely with those of critical care providers-to optimize patient outcomes, reduce development of resistance, and minimize adverse outcomes associated with antibiotic overuse and misuse such as acute kidney injury and Clostridioides difficile-associated disease. Significant opportunities exist in the ICU for critical care clinicians to support stewardship practices at the bedside, including thoughtful and restrained initiation of antimicrobial therapy, use of biomarkers in addition to rapid diagnostics, Staphylococcus aureus screening, and traditional microbiologic culture and susceptibilities to guide antibiotic de-escalation, and use of the shortest duration of therapy that is clinically appropriate. Integration of critical care practitioners into the initiatives of antimicrobial stewardship programs is key to their success. This review summarizes key components of antimicrobial stewardship programs and mechanisms for critical care practitioners to share the responsibility for antimicrobial stewardship.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Programas de Optimización del Uso de los Antimicrobianos / Antiinfecciosos Límite: Humans Idioma: En Revista: Semin Respir Crit Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2022 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Programas de Optimización del Uso de los Antimicrobianos / Antiinfecciosos Límite: Humans Idioma: En Revista: Semin Respir Crit Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2022 Tipo del documento: Article