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. 2021 Aug 26;11(1):131.
doi: 10.1186/s13613-021-00917-2.

Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

Christian Lanckohr  1 , Christian Boeing  1 , Jan J De Waele  2 , Dylan W de Lange  3 , Jeroen Schouten  4 , Menno Prins  5 , Maarten Nijsten  6 , Pedro Povoa  7 , Andrew Conway Morris  8 , Hendrik Bracht  9
Affiliations

Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

Christian Lanckohr et al. Ann Intensive Care. .

Abstract

Background: Severe infections and multidrug-resistant pathogens are common in critically ill patients. Antimicrobial stewardship (AMS) and therapeutic drug monitoring (TDM) are contemporary tools to optimize the use of antimicrobials. The A-TEAMICU survey was initiated to gain contemporary insights into dissemination and structure of AMS programs and TDM practices in intensive care units.

Methods: This study involved online survey of members of ESICM and six national professional intensive care societies.

Results: Data of 812 respondents from mostly European high- and middle-income countries were available for analysis. 63% had AMS rounds available in their ICU, where 78% performed rounds weekly or more often. While 82% had local guidelines for treatment of infections, only 70% had cumulative antimicrobial susceptibility reports and 56% monitored the quantity of antimicrobials administered. A restriction of antimicrobials was reported by 62%. TDM of antimicrobial agents was used in 61% of ICUs, mostly glycopeptides (89%), aminoglycosides (77%), carbapenems (32%), penicillins (30%), azole antifungals (27%), cephalosporins (17%), and linezolid (16%). 76% of respondents used prolonged/continuous infusion of antimicrobials. The availability of an AMS had a significant association with the use of TDM.

Conclusions: Many respondents of the survey have AMS in their ICUs. TDM of antimicrobials and optimized administration of antibiotics are broadly used among respondents. The availability of antimicrobial susceptibility reports and a surveillance of antimicrobial use should be actively sought by intensivists where unavailable. Results of this survey may inform further research and educational activities.

Keywords: Antibiotic; Antimicrobial stewardship; Critical care; Multiresistant bacteria; Therapeutic drug monitoring.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Countries from which participants took part in the A-TEAMICU survey
See this image and copyright information in PMC

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