TY - JOUR
T1 - Principles and Practice of Antibiotic Stewardship in the ICU
AU - Pickens, Chiagozie I.
AU - Wunderink, Richard G.
N1 - 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:
© 2019 American College of Chest Physicians
PY - 2019/7
Y1 - 2019/7
N2 - 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.
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.
KW - antibiotic
KW - resistance
KW - stewardship
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U2 - 10.1016/j.chest.2019.01.013
DO - 10.1016/j.chest.2019.01.013
M3 - Review article
C2 - 30689983
AN - SCOPUS:85064905379
VL - 156
SP - 163
EP - 171
JO - Diseases of the chest
JF - Diseases of the chest
SN - 0012-3692
IS - 1
ER -