Principles and Practice of Antibiotic Stewardship in the ICU

Chiagozie I. Pickens; Richard G. Wunderink

doi:10.1016/j.chest.2019.01.013

Principles and Practice of Antibiotic Stewardship in the ICU

Chiagozie I. Pickens, Richard G. Wunderink^*

^*Corresponding author for this work

Medicine, Pulmonary Division

Research output: Contribution to journal › Review article › peer-review

65 Scopus citations

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.

Original language	English (US)
Pages (from-to)	163-171
Number of pages	9
Journal	CHEST
Volume	156
Issue number	1
DOIs	https://doi.org/10.1016/j.chest.2019.01.013
State	Published - Jul 2019

Funding

FUNDING/SUPPORT: Dr Pickens is supported by National Institutes of Health/National Heart, Lung, and Blood Institute T32 HL076139 Training Program in Lung Sciences grant. FUNDING/SUPPORT: Dr Pickens is supported by National Institutes of Health/ National Heart, Lung, and Blood Institute T32 HL076139 Training Program in Lung Sciences grant. Financial/nonfinancial disclosures: None declared. FUNDING/SUPPORT: Dr Pickens is supported by National Institutes of Health/ National Heart, Lung, and Blood Institute T32 HL076139 Training Program in Lung Sciences grant.

Keywords

antibiotic
resistance
stewardship

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine
Pulmonary and Respiratory Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.chest.2019.01.013

Cite this

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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.",

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note = "Funding Information: FUNDING/SUPPORT: Dr Pickens is supported by National Institutes of Health/National Heart, Lung, and Blood Institute T32 HL076139 Training Program in Lung Sciences grant. FUNDING/SUPPORT: Dr Pickens is supported by National Institutes of Health/ National Heart, Lung, and Blood Institute T32 HL076139 Training Program in Lung Sciences grant. Financial/nonfinancial disclosures: None declared. FUNDING/SUPPORT: Dr Pickens is supported by National Institutes of Health/ National Heart, Lung, and Blood Institute T32 HL076139 Training Program in Lung Sciences grant. Publisher Copyright: {\textcopyright} 2019 American College of Chest Physicians",

year = "2019",

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AB - 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.

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Principles and Practice of Antibiotic Stewardship in the ICU

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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