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Review
. 2022 Nov 15;3(3):244-253.
doi: 10.1016/j.jointm.2022.10.001. eCollection 2023 Jul 31.

Antimicrobial stewardship in the intensive care unit

Zeynep Ture  1 , Rahmet Güner  2 , Emine Alp  2
Affiliations
Review

Antimicrobial stewardship in the intensive care unit

Zeynep Ture et al. J Intensive Med. .

Abstract

High resistance rates to antimicrobials continue to be a global health threat. The incidence of multidrug-resistant (MDR) microorganisms in intensive care units (ICUs) is quite high compared to in the community and other units in the hospital because ICU patients are generally older, have higher numbers of co-morbidities and immune-suppressed; moreover, the typically high rates of invasive procedures performed in the ICU increase the risk of infection by MDR microorganisms. Antimicrobial stewardship (AMS) refers to the implementation of coordinated interventions to improve and track the appropriate use of antibiotics while offering the best possible antibiotic prescription (according to dose, duration, and route of administration). Broad-spectrum antibiotics are frequently preferred in ICUs because of greater infection severity and colonization and infection by MDR microorganisms. For this reason, a number of studies on AMS in ICUs have increased in recent years. Reducing the use of broad-spectrum antibiotics forms the basis of AMS. For this purpose, parameters such as establishing an AMS team, limiting the use of broad-spectrum antimicrobials, terminating treatments early, using early warning systems, pursuing infection control, and providing education and feedback are used. In this review, current AMS practices in ICUs are discussed.

Keywords: Antimicrobial stewardship; Appropriate antimicrobial; Critically ill; Infection control; Intensive care unit; Multidrug-resistant.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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