Table 1 Practices promoting the optimization of antimicrobial use in the intensive care unit setting
From: Optimizing antibiotic therapy in the intensive care unit setting
Provide adequate initial treatment of serious infections (e.g. pneumonia, bloodstream) |
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Awareness of predominant causative pathogens |
Up to date unit-specific pathogen antibiograms |
Drainage of abscesses, empyema cavities, other infected fluid collections |
Removal of infected foreign bodies (e.g. central venous catheters) |
Monitor serum drug concentrations when appropriate to achieve therapeutic levels |
Minimize antibiotic pressures promoting resistance |
Avoid prolonged courses of empiric antibiotic therapy |
Consider de-escalation of antibiotics based on available microbiologic data and clinical course |
Use narrow spectrum antibiotics when supported by clinical situation and culture data |
Establish appropriate thresholds for prescribing antibiotics |
Develop predetermined criteria for the discontinuation of antimicrobial therapy |