• Infect. Dis. Clin. North Am. · Sep 2017

    Review Case Reports

    Antimicrobial Stewardship Approaches in the Intensive Care Unit.

    • Sarah B Doernberg and Henry F Chambers.
    • Division of Infectious Diseases, Department of Medicine, University of California, 513 Parnassus Avenue, Box 0654, San Francisco, CA 94143, USA. Electronic address: sarah.doernberg@ucsf.edu.
    • Infect. Dis. Clin. North Am. 2017 Sep 1; 31 (3): 513-534.

    AbstractAntimicrobial stewardship programs aim to monitor, improve, and measure responsible antibiotic use. The intensive care unit (ICU), with its critically ill patients and prevalence of multiple drug-resistant pathogens, presents unique challenges. This article reviews approaches to stewardship with application to the ICU, including the value of diagnostics, principles of empirical and definitive therapy, and measures of effectiveness. There is good evidence that antimicrobial stewardship results in more appropriate antimicrobial use, shorter therapy durations, and lower resistance rates. Data demonstrating hard clinical outcomes, such as adverse events and mortality, are more limited but encouraging; further studies are needed.Copyright © 2017 Elsevier Inc. All rights reserved.

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