The most common mistakes in intensive care – antibiotics
Authors:
V. Adámková
Authors‘ workplace:
Univerzity Karlovy a Všeobecné fakultní nemocnice Praha, Česká republika
; Klinická mikrobiologie a ATB centrum Ústavu lékařské biochemie a laboratorní diagnostiky 1. lékařské fakulty
Published in:
Rozhl. Chir., 2024, roč. 103, č. 3, s. 79-83.
Category:
Review
doi:
https://doi.org/10.33699/PIS.2024.103.3.79–83
Overview
The enormous increase in antibiotic resistance and the limited spectrum of new, effective antibiotics are the reasons why we should think about a rational approach to anti-infective therapy. The excessive and non-indicated use of antibiotics while treating critically ill patients can be found quite often in clinical practice. Antibiotic therapy is usually indicated empirically, or it is only based on therapeutic indecision, not just in ICU patients. The antibiotics are administered before taking a sample for microbiological analysis or there is no therapy adjustment based on the laboratory findings. The solution lies in antibiotic stewardship, which is the way to ensure that antibiotics will be sufficiently effective in years to come.
Keywords:
Prophylaxis – resistance – antibiotic stewardship – cumulative antibiograms – algorithm of antibiotic treatment
Sources
- https://www.nobelprize.org/uploads/ 2018/06/fleming-lecture.pdf.
- Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T. 2015; 40(4):277–283.
- D‘Costa VM, King CE, Kalan L, et al. Antibiotic resistance is ancient. Nature 2011; 477:457–461. doi: 10.1038/nature10388.
- Theuretzbacher U, Outterson K, Engel A, et al. The global preclinical antibacterial pipeline. Nat Rev Microbiol. 2020;18(5):275–285. doi: 10.1038/s41579-019-0288-0.
- Forslund K, Sunagawa S, Kultima JR, et al. Country-specific antibiotic use practices impact the human gut resistome. Genome Res. 2013 Jul;23(7):1163–1169. doi:10.1101/gr.155465.113.
- Francino MP. Antibiotics and the human gut microbiome: Dysbioses and accumulation of resistances. Front. Microbiol. 2016;6:1543. doi:10.3389/fmicb.2015.01543.
- Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev. 2010;74(3):417–433. doi:10.1128/ MMBR.00016-10.
- Wencewicz TA. Crossroads of antibiotic resistance and biosynthesis. J Mol Biol. 2019;431(18):3370–3399. doi:10.1016/j.jmb.2019.06.033.
- Bassetti M, De Waele JJ, Eggimann P, et al. Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria. Intensive Care Med. 2015;41:776–795. doi:10.1007/s00134-015-3719-z.
- Hindler JF, Stelling J. Analysis and presentation of cumulative antibiograms: a new consensus guideline from the Clinical and Laboratory Standards Institute. Clin Infect Dis. 2007;44(6):867–873. doi:10.1086/511864.
- Vardakas KZ, Dimitrios K, Matthaiou DK, et al. Characteristics, risk factors and outcomes of carbapenem-resistant Klebsiella pneumoniae infections in the intensive care unit. J Infect. 2015;70:592. doi:10.1016/j.jinf.2014.11.003.
- Lepape A, Jean A, De Waele J, et al. European intensive care physicians‘ experience of infections due to antibiotic-resistant bacteria. Antimicrob Resist Infect Control. 2020 Jan;9:1. doi:10.1186/ s13756-019-0662-8.
- Kollef MH, Bassetti M, Francois B, et al. The intensive care medicine research agenda on multidrug-resistant bacteria, antibiotics, and stewardship. Intensive Care Med. 2017;43(9):1187–1197. doi:10.1007/ s00134-017-4682-7.
- Debroas D, Siguret C. Viruses as key reservoirs of antibiotic resistance genes in the environment. ISME Journal 2019;13 (11):2856–2867. doi:10.1038/s41396-019-0478-9.
- Tamma PD, Cosgrove SE. Antimicrobial stewardship. Infect Dis Clin North Am. 2011;25:245–260.
- Dyar OJ, Pagani L, Pulcini C. Strategies and challenges of antimicrobial stewardship in long-term care facilities. Clin Microbiol Infect. 2015;21:10–9. doi:10.1016/j. cmi.2014.09.005.
- Guardabassi L, Prescott JF. Antimicrobial stewardship in small animal veterinary practice. Vet Clin North Am Small Anim Pract. 2015;45:361–376. doi:10.1016/j. cvsm.2014.11.005.
- World Health Organization. Consultation on options for establishing a global development and stewardship framework. WHO; 2016. Available at: http://www. who.int/phi/news/consultation_stewardship-framework/en/.
- McGowan JE, Gerding DN. Does antibiotic restriction prevent resistance? New Horiz. 1996;4:370–376.
- Fishman N. Policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol. 2012;33:322–327. doi:10.1086/665010.
- Dyar OJ, Obua C, Chandy S, et al. Using antibiotics responsibly: are we there yet? Future Microbiol. 2016;11:1057–1071. doi:10.2217/fmb-2016-0041.
- CLSI. Analysis and presentation of cumulative antimicrobial susceptibility test data; Approved guideline 5th edition. CLSI document M39-A4. Wayne, PA: Clinical and Laboratory Standards Institute 2014.
- Moehring RW, Hazen KC, Hawkins MR, et al. Challenges in preparation of cumulative antibiogram reports for community hospitals. J Clin Microbiol. 2015;53(9):2977–2982. doi:10.1128/JCM.01077-15.
- Assimakopoulos SF, Triantos C, Maroulis I, et al. The role of the gut barrier function in health and disease. Gastroenterology Res. 2018 Aug;11(4):261–263. doi:10.14740/gr1053w.
- Adámková V. The role of new antibiotics in intra-abdominal infections in the era of multi-resistant bacteria. Rozhl Chir. 2019;98(4):145–151.
- Marik PE, Flemmer M. The immune response to surgery and trauma: Implications for treatment. J Trauma Acute Care Surg. 2012 Oct;73(4):801–808. doi:10.1097/TA.0b013e318265cf87.
- Qiao Z, Li Z, Li J, et al. Bacterial translocation and change in intestinal permeability in patients after abdominal surgery. J Huazhong Univ Sci Technolog Med Sci. 2009 Aug;29(4):486–491. doi:10.1007/ s11596-009-0419-3.
- Altshuler AE, Kistler EB, Schmid-Schönbein GW. Autodigestion: Proteolytic degradation and multiple organ failure in shock. Shock 2016 May;45(5):483–933. doi:10.1097/SHK.0000000000000544.
- Coppa G, Eng K. Factors involved in antibiotic selection in elective colon and rectal surgery. Surgery 1988;104:853–858.
- Itani KM, Wilson SE, Awad SS, et al. Ertapenem versus cefotetan prophylaxis in elective colorectal surgery. N Engl J Med. 2006;335:2640–2651. doi:10.1056/NEJMoa054408.
- Gorbach SL, Condon RE, Conte JE Jr, et al. Evaluation of new anti-infective drugs for surgical prophylaxis. Clin Infect Dis. 1992;15(1):313–338. doi:10.1093/clind/15.supplement_1.s313.
MUDr. Václava Adámková
Klinická mikrobiologie – ATB centrum
Ke Karlovu 2, 121 09 Praha 2
e-mail: vaclava.adamkova@vfn.cz
ORCID: 0000-0002-7629-5365
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
![Issue 3](https://www.prolekare.cz/media/cache/resolve/journal_issue/media/image_pdf/42032dcb0fd50e7e0758c3af1ccb85d1.jpg)
2024 Issue 3
Most read in this issue
- The most common mistakes in intensive care – antibiotics
- Spigelian hernia
- AI for better surgical vision?
- News