De-escalation of antibiotic therapy as a part of care strategy about critically ill patients

Czech version

Authors: V. Adámková
Authors‘ workplace: Klinická mikrobiologie a ATB centrum, Ústav lékařské biochemie a laboratorní diagnostiky, Všeobecná fakultní nemocnice v Praze a 1. lékařská fakulta Univerzity Karlovy
Published in: Anest. intenziv. Med., 30, 2019, č. 3-4, s. 145-152
Category: Intensive Care Medicine - Review Article

Overview

One of the biggest problems of medicine is the extreme increase of bacterial resistance making the antibiotic treatment harder on the ICU as well as in the community. In order to maintain the efficacy of existing antibiotics, close interdisciplinary cooperation in diagnostics of infectious diseases along with an appropriate choice of antibiotics is crucial. Antibiotics must only be used for the treatment of bacterial infections, not as treatment of natural bacterial colonisations. Although de-escalation is one of the strategies of antibiotic stewardship, its role in intensive care is still unclear. For any modification in the antibiotic treatment, the microbiological results must be related to the patient’s clinical status to prevent damage to patient’s health.

Keywords:

colonisation – resistance – multidrug resistant bacteria – de-escalation

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