Rational empiric antibiotic prescription in the ICU

Abstract

The prescribing of antibiotics in the ICU is usually empiric, given the critical nature of the conditions of patients hospitalized there. Appropriate antibiotic utilization in this setting is crucial not only in ensuring an optimal outcome, but in curtailing the emergence of resistance and containing costs. We propose that research in the ICUs is vitally important in guiding antibiotic prescription practices and, therefore, the achievement of above-stated goals. There is wide institutional diversity in the relative prevalence of predominant pathogens and their antimicrobial susceptibilities, and within individual ICUs there exist unique patient populations with varying risks for and susceptibilities to infections and specific pathogens. Appropriate antibiotic prescription practices should be formulated based on surveillance studies and research at individual ICUs; these goals can be accomplished utilizing existing resources.