Antimicrobial stewardship of β-lactams in intensive care units

被引:10
作者
Cotta, Menino Osbert [1 ,2 ]
Roberts, Jason A. [1 ,3 ]
Tabah, Alexis [1 ,3 ]
Lipman, Jeffrey [1 ,3 ]
Vogelaers, Dirk [4 ]
Blot, Stijn [1 ,4 ]
机构
[1] Univ Queensland, Burns Trauma & Crit Care Res Ctr, Brisbane, Qld, Australia
[2] Univ Melbourne, Royal Melbourne Hosp, Dept Med, Melbourne, Vic 3050, Australia
[3] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia
[4] Univ Ghent, Dept Internal Med, Fac Med & Hlth Sci, B-9000 Ghent, Belgium
关键词
antibiotics; antimicrobial resistance; beta-lactam antibiotics; critical care unit; infection; intensive care unit; stewardship; VENTILATOR-ASSOCIATED PNEUMONIA; CRITICALLY-ILL PATIENTS; GRAM-NEGATIVE BACTERIA; CLINICAL-PRACTICE GUIDELINES; RANDOMIZED CONTROLLED-TRIAL; RENAL REPLACEMENT THERAPY; DE-ESCALATION THERAPY; ANTIBIOTIC-THERAPY; DECISION-SUPPORT; SEVERE SEPSIS;
D O I
10.1586/14787210.2014.902308
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Stewardship of all antimicrobials, including beta-lactam antibiotics, has gained in prominence over the last decade. Appropriate use of these agents has become vitally important; especially in the treatment and management of the critically ill. Opportunities therefore exist to develop innovations to optimise the use of antimicrobials in places like the intensive care unit. The next few years represent an important window in which routine antimicrobial stewardship principles such as surveillance of local ecology, minimising overlap of spectrum of activity and prompt de-escalation upon review of cultures can be integrated with new technologies including improved diagnostic techniques, individualised dosing strategies and computerised decision support. It is important though, that these measures to improve stewardship in the intensive care unit continue to be critically evaluated in the literature.
引用
收藏
页码:581 / 595
页数:15
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