Management of antibiotic resistance in the intensive care unit setting

Research output: Contribution to journalArticlepeer-review

Abstract

Over the past few decades, an alarming increase of infections caused by antibiotic-resistant pathogens, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus species, carbapenem-resistant Pseudomonas aeruginosa, extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella spp., and multidrug-resistant Acinetobacter spp., has been observed, particularly in intensive care units. For clinicians, the rising resistance rate observed in nosocomial pathogens, when coupled with the lack of effective antimicrobials, represents the real challenge in the therapeutic management of critically ill patients. The contribution of clinicians in minimizing the increasing trend of resistance is represented by reduction of the patients' exposure to antibiotics, which reduces the resistance-selecting pressure, and by avoiding unnecessary antibiotic treatments. Recent issues on strategies to minimize resistance development and to appropriately manage critically ill patients with infections caused by multidrug-resistant organisms in the intensive care unit setting are discussed in this article.

Original languageEnglish
Pages (from-to)289-302
Number of pages14
JournalExpert Review of Anti-Infective Therapy
Volume8
Issue number3
DOIs
Publication statusPublished - Mar 2010

Keywords

  • Antimicrobial combination therapy
  • Antimicrobial resistance
  • Antimicrobial stewardship program
  • De-escalation therapy
  • Intensive care
  • Severe infections
  • Vancomycin minimal inhibitory concentration

ASJC Scopus subject areas

  • Microbiology
  • Virology
  • Infectious Diseases
  • Microbiology (medical)

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