Role of Unit-Specific Combination Antibiograms for Improving the Selection of Appropriate Empiric Therapy for Gram-Negative Pneumonia

2011 ◽  
Vol 32 (3) ◽  
pp. 289-292 ◽  
Author(s):  
Jason M. Pogue ◽  
Cesar Alaniz ◽  
Peggy L. Carver ◽  
Melissa Pleva ◽  
Duane Newton ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Combination Therapy ◽  
Empiric Therapy ◽  
Gram Negative ◽  
Specific Combination ◽  
Selection Of

In an effort to improve the selection of appropriate empiric gram-negative therapy for pneumonia, we examined intensive care unit-specific combination antibiograms. These antibiograms were able to predict appropriate empiric gram-negative therapy. Empiric combination therapy based on unit-specific combination antibiograms may aid in the selection of therapy for gram-negative pneumonia.

Appropriate Antibiotic Selection and Use for Intensive Care Unit Patients, Part I: Rationale for Antibiotic Choices

2018 ◽  
Author(s):  
Richard M Pino ◽  
Molly Paras ◽  
Erica S Shenoy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Vascular Supply ◽  
Surgical Patient ◽  
Risk Of Infection ◽  
Antibiotic Selection ◽  
Key Words Antibiotics ◽  
Surgical Icu ◽  
Selection Of

The aim of this review is to help clinicians optimize treatment of infections and reduce adverse events. With that goal in mind, we discuss the basis for the selection of antibiotics for the surgical patient in the intensive care unit (ICU), the mechanism of antibiotic action, and resistance of pathogens to antibiotic therapy—factors that may affect antibiotic levels, the rationales for dosing, and the role of antimicrobial stewardship programs. The evaluation and management of infections in critically ill patients are uniquely different from those of the general patient population. Age, medical comorbidities, alterations in anatomy, changes in vascular supply, insertion of vascular conduits, and orthopedic hardware are some factors that increase the risk of infection and influence antibiotic choice in the surgical ICU patient.  Key words: antibiotics, antibiotic resistance, antibiotic stewardship, intensive care unit

Surveillance of multidrug-resistant gram-negative bacilli in a neonatal intensive care unit: prominent role of cross transmission

2007 ◽  
Vol 35 (4) ◽  
pp. 222-230 ◽  
Author(s):  
Caterina Mammina ◽  
Paola Di Carlo ◽  
Domenico Cipolla ◽  
Mario Giuffrè ◽  
Alessandra Casuccio ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Multidrug Resistant ◽  
Gram Negative ◽  
Cross Transmission

Highly Resistant Microorganisms in a Teaching Hospital: The Role of Horizontal Spread in a Setting of Endemicity

2008 ◽  
Vol 29 (12) ◽  
pp. 1110-1117 ◽  
Author(s):  
Ina Willemsen ◽  
Marlies Mooij ◽  
Marsha van der Wiel ◽  
Diana Bogaers ◽  
Madelon van der Bijl ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Transmission ◽  
Incidence Density ◽  
Reproduction Rate ◽  
Gram Negative ◽  
Relative Contribution ◽  
Admission Data ◽  
Horizontal Spread

Objective.To determine the incidence density of highly resistant organisms (HROs) and the relative contribution of horizontal spread in a setting of endemicity.Methods.Prospective surveillance was performed among hospitalized patients during an 18-month period. Enterobacteriaceae, non-fermentative gram-negative bacilli,Staphylococcus aureus, Streptococcus pneumoniae,andEnterococcus faecium—all considered highly resistant, according to Dutch guidelines—were included. Epidemiological linkage and nosocomial transmission were determined on the basis of molecular typing and hospital admission data.Results.From 119 patients, we recovered a total of 170 unique HRO isolates, as follows:Escherichia coli,96 isolates;Klebsiellaspecies, 11 isolates;Enterobacterspecies, 8 isolates;Proteusspecies, 9 isolates;Citrobacterspecies, 5 isolates;Pseudomonasspecies, 5 isolates;Aci-netobacterspecies, 3 isolates;Morganellaspecies, 2 isolates;Salmonellaspecies, 1 isolate;Serratiaspecies, 1 isolate;S. pneumoniae,20 isolates; andS. aureus,9 isolates. No vancomycin-resistantE. faeciumwas found. The incidence density was 4.3 HRO isolates per 10,000 patient-days. The majority of HRO isolates were unique, and nosocomial transmission was observed 4 times for highly resistant gram-negative bacilli (case reproduction rate, 0.05) and 4 times for penicillin-nonsusceptibleS. pneumoniae(case reproduction rate, 0.29). A stay on the intensive care unit was the main determinant for the recovery of an HRO.Conclusion.Nosocomial transmission of HROs was observed 8 times during the 18-month period. The intensive care unit was identified as the main reservoir of horizontal spread of HROs. This study shows that nosocomial transmission of HROs is largely preventable using transmission precautions.

The role of intestinal colonization with Gram-negative bacteria as a source for intensive care unit-acquired bacteremia*

2011 ◽  
Vol 39 (5) ◽  
pp. 961-966 ◽  
Author(s):  
Evelien A. N. Oostdijk ◽  
Anne Marie G. A. de Smet ◽  
Jozef Kesecioglu ◽  
Marc J. M. Bonten
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gram Negative Bacteria ◽  
Intestinal Colonization ◽  
Gram Negative

Appropriate Antibiotic Selection and Use for Intensive Care Unit Patients, Part I: Rationale for Antibiotic Choices

2017 ◽  
Author(s):  
Richard M Pino ◽  
Molly Paras ◽  
Erica S Shenoy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Vascular Supply ◽  
Surgical Patient ◽  
Risk Of Infection ◽  
Antibiotic Selection ◽  
Key Words Antibiotics ◽  
Surgical Icu ◽  
Selection Of

The aim of this review is to help clinicians optimize treatment of infections and reduce adverse events. With that goal in mind, we discuss the basis for the selection of antibiotics for the surgical patient in the intensive care unit (ICU), the mechanism of antibiotic action, and resistance of pathogens to antibiotic therapy—factors that may affect antibiotic levels, the rationales for dosing, and the role of antimicrobial stewardship programs. The evaluation and management of infections in critically ill patients are uniquely different from those of the general patient population. Age, medical comorbidities, alterations in anatomy, changes in vascular supply, insertion of vascular conduits, and orthopedic hardware are some factors that increase the risk of infection and influence antibiotic choice in the surgical ICU patient.  Key words: antibiotics, antibiotic resistance, antibiotic stewardship, intensive care unit

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