Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria.

Details

Serval ID
serval:BIB_A069D7526296
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria.
Journal
Intensive Care Medicine
Author(s)
Bassetti M., De Waele J.J., Eggimann P., Garnacho-Montero J., Kahlmeter G., Menichetti F., Nicolau D.P., Paiva J.A., Tumbarello M., Welte T., Wilcox M., Zahar J.R., Poulakou G.
ISSN
1432-1238 (Electronic)
ISSN-L
0342-4642
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
41
Number
5
Pages
776-795
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
The antibiotic pipeline continues to diminish and the majority of the public remains unaware of this critical situation. The cause of the decline of antibiotic development is multifactorial and currently most ICUs are confronted with the challenge of multidrug-resistant organisms. Antimicrobial multidrug resistance is expanding all over the world, with extreme and pandrug resistance being increasingly encountered, especially in healthcare-associated infections in large highly specialized hospitals. Antibiotic stewardship for critically ill patients translated into the implementation of specific guidelines, largely promoted by the Surviving Sepsis Campaign, targeted at education to optimize choice, dosage, and duration of antibiotics in order to improve outcomes and reduce the development of resistance. Inappropriate antimicrobial therapy, meaning the selection of an antibiotic to which the causative pathogen is resistant, is a consistent predictor of poor outcomes in septic patients. Therefore, pharmacokinetically/pharmacodynamically optimized dosing regimens should be given to all patients empirically and, once the pathogen and susceptibility are known, local stewardship practices may be employed on the basis of clinical response to redefine an appropriate regimen for the patient. This review will focus on the most severely ill patients, for whom substantial progress in organ support along with diagnostic and therapeutic strategies markedly increased the risk of nosocomial infections.
Pubmed
Web of science
Create date
31/05/2015 8:39
Last modification date
20/08/2019 15:06
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