[Antibiotic resistance: development in surgical intensive care]. / Resistenzentwicklung in der operativen Intensivtherapie.

ABSTRACT

BACKGROUND: During the last years we have always found an increase of antibiotic resistance. This increase is combined with high antibiotic consumption. The reasons for the problems are mis-takes in the prescription of antibiotics and the -in-crease of risk-patients because of demographic aging and the development and progress of surgery and medicine. MATERIAL AND METHOD: We describe the general development of bacterial resistance and factors that influence it. Data from two intensive care units are evaluated. We describe the main anti-biotic-resistant isolates for surgery and the mechanisms to avoid the development of bacterial resistance. RESULTS: The emergency increase of bacterial resistance shows severe clinical and economical problems. For surgery especially the multidrug-resistant Gram-negative organisms represent an important hygienic and therapeutic problem. CONCLUSION: In order to positively influence the development of bacterial resistance, strict guidelines, especially for intensive stations, must be consequently applied and controlled. In spite of knowledge of these problems for a number of years many reserves are still available for the care of critical patients.