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- W2460866921 abstract "Antibiotics are life-saving drugs and among the most important therapeutic weapons of the intensive care unit (ICU) physician. In severe bacterial infection, community-acquired, healthcare-associated and hospital-acquired, timely administration of antibiotic therapy active against the causal pathogen is one of the main determinants of a favorable patient outcome. On the other hand, it is an undeniable fact that antibiotics need to be used judiciously, as the induction and rapid spread of resistance threatens to reduce their lifespan. Trying to spare our current antibiotic armamentarium has become urgent, as development of new antibiotics has lagged completely behind the emergence of resistance [1]. As such, the ICU physician faces a daily dilemma: Using antibiotics may improve individual patient outcome (inasmuch as clinical deterioration is due to bacterial infection), but will induce selection pressure and potential harm to future patients or to the same patient in the future, whereas withholding antibiotics will avoid selection pressure but may put the individual patient at increased risk of harm caused by an untreated infection. This dilemma is made worse by the fact that, in critically ill patients, clinical presentation of hospital-acquired infection may be subtle or atypical at the time when the decision of whether or not to start antibiotics has to be made. Moreover, at that time, the causative pathogen is usually not identified but assumed to be potentially resistant to multiple antibiotics. These uncertainties lead ICU physicians to err on the side of caution for the immediate benefit of the individual patient and to accept a certain overuse of broad-spectrum antibiotics. However, as the ecological impact of antibiotic consumption is escalating, efforts have been made to reconcile maximum short-term patient safety (the least number of ‘missed’ infections or ‘missed’ pathogens) with a reduction in overall antibiotic use." @default.
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- W2460866921 date "2016-01-01" @default.
- W2460866921 modified "2023-09-24" @default.
- W2460866921 title "Reducing Antibiotic Use in the ICU: A Time-Based Approach to Rational Antimicrobial Use" @default.
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- W2460866921 doi "https://doi.org/10.1007/978-3-319-27349-5_2" @default.
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