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Review
. 2019 Jul;156(1):163-171.
doi: 10.1016/j.chest.2019.01.013. Epub 2019 Jan 25.

Principles and Practice of Antibiotic Stewardship in the ICU

Chiagozie I Pickens  1 , Richard G Wunderink  2
Affiliations
Review

Principles and Practice of Antibiotic Stewardship in the ICU

Chiagozie I Pickens et al. Chest. 2019 Jul.

Abstract

In the face of emerging drug-resistant pathogens and a decrease in the development of new antimicrobial agents, antibiotic stewardship should be practiced in all critical care units. Antibiotic stewardship should be a core competency of all critical care practitioners in conjunction with a formal antibiotic stewardship program (ASP). Prospective audit and feedback, and antibiotic time-outs, are effective components of an ASP in the ICU. As rapid diagnostics are introduced in the ICU, assessment of performance and effect on outcomes will clearly be needed. Disease-specific stewardship for community-acquired pneumonia that relies on clinical pathways may be particularly high-yield. Computerized decision support has the potential to individualize stewardship for specific patients. Finally, infection control and prevention is the cornerstone of every ASP.

Keywords: antibiotic; resistance; stewardship.

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References

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