Infectious Complications: Understanding Appropriate Antibiotic Choice and Utilization

  • Massimo Sartelli
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)


The management of infections in surgical intensive care unit (ICU) patients poses specific challenges because multidrug resistance is increasingly described and changes in pharmacokinetics may require different dosing strategies. Severe infections in surgical patients may be the reason for admission in some but may also develop during intensive care unit stay in other patients. These infections are an important burden in critical care, in terms of morbidity, mortality, and resource use.


Antibiotics Sepsis Septic shock Antimicrobial resistance Critically ill patients 


  1. 1.
    Sartelli M, Kluger Y, Ansaloni L, Hardcastle TC, Rello J, Watkins RR, et al. Raising concerns about the Sepsis-3 definitions. World J Emerg Surg. 2018;25(13):6.CrossRefGoogle Scholar
  2. 2.
    Sartelli M, Weber DG, Ruppé E, Bassetti M, Wright BJ, Ansaloni L, et al. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA). World J Emerg Surg. 2016;11:33.CrossRefGoogle Scholar
  3. 3.
    Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. 2017;43(3):304–77.CrossRefGoogle Scholar
  4. 4.
    Shani V, Muchtar E, Kariv G, Robenshtok E, Leibovici L. Systematic review and meta-analysis of the efficacy of appropriate empiric antibiotic therapy for sepsis. Antimicrob Agents Chemother. 2010;54:4851–63.CrossRefGoogle Scholar
  5. 5.
    De Waele J, De Bus L. How to treat infections in a surgical intensive care unit. BMC Infect Dis. 2014;14:193. Scholar
  6. 6.
    Gomez-Simmonds A, Nelson B, Eiras DP, Loo A, Jenkins SG, Whittier S, Calfee DP, Satlin MJ, Kubin CJ, Furuya EY. Combination regimens for treatment of Carbapenem-resistant Klebsiella pneumoniae bloodstream infections. Antimicrob Agents Chemother. 2016;60(6):3601–7.CrossRefGoogle Scholar
  7. 7.
    Pea F, Viale P. Bench-to-bedside review: appropriate antibiotic therapy in severe sepsis and septic shock—does the dose matter? Crit Care. 2009;13(3):214.CrossRefGoogle Scholar
  8. 8.
    Sartelli M, Catena F, Abu-Zidan FM, Ansaloni L, Biffl WL, Boermeester MA, et al. Management of intra-abdominal infections: recommendations by the WSES 2016consensus conference. World J Emerg Surg. 2017;12:22.CrossRefGoogle Scholar
  9. 9.
    Sartelli M, Catena F, Ansaloni L, Coccolini F, Di Saverio S, Griffiths EA. Duration of antimicrobial therapy in treating complicated intra-abdominal infections: a comprehensive review. Surg Infect. 2016;17(1):9–12.CrossRefGoogle Scholar
  10. 10.
    Hochreiter M, Köhler T, Schweiger AM, Keck FS, Bein B, von Spiegel T, Schroeder S. Procalcitonin to guide duration of antibiotic therapy in intensive care patients: a randomized prospective controlled trial. Crit Care. 2009;13(3):R83.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Massimo Sartelli
    • 1
  1. 1.Department of SurgeryMacerata HospitalMacerataItaly

Personalised recommendations