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Semin Respir Crit Care Med 2002; 23(5): 497-502
DOI: 10.1055/s-2002-35721
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Antibiotic Utilization Strategies to Limit Antimicrobial Resistance

Daniel P. Raymond, Shawn J. Pelletier, Robert G. Sawyer
  • Department of Surgery, University of Virginia Health Systems, Charlottesville, Virginia
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Publication History

Publication Date:
25 November 2002 (online)

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ABSTRACT

Antimicrobial resistance is now being recognized as a major factor determining morbidity, mortality, and cost in the intensive care unit (ICU). Various strategies to limit its spread have evolved with our understanding and are based on four basic principles: infection prevention, infection eradication, containment of resistant species, and optimization of antibiotic utilization. The optimization of antibiotic utilization, at its most basic level, is the appropriate use of antibiotics and the limitation of unnecessary antibiotic administration/exposure consisting of appropriate diagnosis, acquiring appropriate culture and sensitivity data, implementing the most appropriate treatment, selecting appropriate antibiotics, and dosing appropriately. In addition various antibiotic utilization strategies including antibiotic utilization guidelines, formulary restriction, and antibiotic cycling or rotation have evolved from our understanding of the impact of changes in antibiotic utilization on subsequent antibiotic susceptibility patterns. These strategies can be utilized as a part of a multidisciplinary approach to limit the appearance and dissemination of antimicrobial resistance in our ICUs.

KEYWORDS

Antibiotics - antibiotic resistance - antibiotic cycling

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