• Antibiotics are not anti-pyretic agents … they should be used only when bacterial infection is strongly suspected! (see Chapters 10 and 13).

• Initial appropriate anti-microbial coverage is the most important factor affecting outcome in patients with sepsis.

• Combination anti-microbial therapy is the most effective mechanism of providing empiric broad coverage in critically ill septic patients.


Necrotizing Fasciitis Spontaneous Bacterial Peritonitis Epithelial Line Fluid Microbiological Cure Rate Comparable Clinical Effectiveness 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Kollef MH, Napolitano LM, Solomkin JS, et al. Health care-associated infection (HAI): a critical appraisal of the emerging threat―proceedings of the HAI Summit. Clin Infect Dis. 2008;47(Suppl 2):S55–S99.PubMedCrossRefGoogle Scholar
  2. 2.
    Evans HL, Lefrak SN, Lyman J, et al. Cost of Gram-negative resistance. Crit Care Med. 2007;35:89–95.PubMedCrossRefGoogle Scholar
  3. 3.
    A’Court CH, Garrard CS, Crook D, et al. Microbiological lung surveillance in mechanically ventilated patients, using non-directed bronchial lavage and quantitative culture. Q J Med. 1993;86:635–648.PubMedCrossRefGoogle Scholar
  4. 4.
    Dennesen PJ, Kessels AG, Ramsay G, et al. Resolution of infectious parameters after antimicrobial therapy in patients with ventilator-associated pneumonia. Am J Respir Crit Care Med. 2001;163:1371–1375.PubMedGoogle Scholar
  5. 5.
    Chastre J, Wolff M, Fagon JY, et al. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA. 2003;290:2588–2598.PubMedCrossRefGoogle Scholar
  6. 6.
    Marik PE. Definition of sepsis: not quite time to dump SIRS? Crit Care Med. 2002;30:706–708.PubMedCrossRefGoogle Scholar
  7. 7.
    Nobre V, Harbarth S, Graf GD, et al. Use of procalcitonin to shorten antibiotic treatment duration in septic patients. A randomized trial. Am J Respir Crit Care Med. 2008;177:498–505.PubMedCrossRefGoogle Scholar
  8. 8.
    Hochreiter M, Kohler T, Schweiger AM, et al. Procalcitonin to guide duration of antibiotic therapy in the intensive care patients: a randomized prospective controlled trial. Crit Care. 2009;13:R83.PubMedCrossRefGoogle Scholar
  9. 9.
    Schuetz P, Christ-Crain M, Thomann R, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotics use in lower respiratory tract infections. The ProHOSP randomized controlled trial. JAMA. 2009;302:1059–1066.PubMedCrossRefGoogle Scholar
  10. 10.
    Schroeder S, Hochreiter M, Koehler T, et al. Procalcitonin (PCT)-guided algorithm reduces length of antibiotic treatment in surgical intensive care patients with severe sepsis: results of a prospective randomized study. Langenbecks Arch Surg. 2009;394:221–226.PubMedCrossRefGoogle Scholar
  11. 11.
    Isakow W, Kollef MH. Preventing ventilator-associated pneumonia: an evidence-based approach of modifiable risk factors. Semin Resp Crit Care Med. 2006;27:5–17.CrossRefGoogle Scholar
  12. 12.
    Wunderink RG, Rello J, Cammarata SK, et al. Linezolid vs vancomycin: analysis of two double-blind studies of patients with methicillin-resistant Staphylococcus aureus nosocomial pneumonia. Chest. 2003;124:1789–1797.PubMedCrossRefGoogle Scholar
  13. 13.
    Wunderink RG, Mendelson MH, Somero MS, et al. Early microbiological response to linezolid vs vancomycin in ventilator-associated pneumonia due to methicillin-resistant Staphylococcus aureus. Chest. 2008;134:1200–1207.PubMedCrossRefGoogle Scholar
  14. 14.
    Rubinstein E, Kollef MH, Nathwani D. Pneumonia caused by methicillin-resistant Staphylococcus aureus. Clin Infect Dis. 2008;46(Suppl 5):S378–S385.PubMedCrossRefGoogle Scholar
  15. 15.
    Boselli E, Breilh D, Duflo F, et al. Steady-state plasma and intrapulmonary concentrations of cefepime administered in continuous infusion in critically ill patients with severe pneumonia. Crit Care Med. 2003;31:2102–2106.PubMedCrossRefGoogle Scholar
  16. 16.
    Boselli E, Breilh D, Rimmele T, et al. Alveolar concentrations of piperacillin/tazobactam administered in continuous infusion to patients with ventilator-associated pneumonia. Crit Care Med. 2008;36:1500–1506.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Pulmonary and Critical Care MedicineEastern Virginia Medical SchoolNorfolkUSA

Personalised recommendations