Empiric Antibiotics in Critical Illness: Do they Help or Harm?

  • M. A. Aarts
  • J. C. Marshall
Conference paper

Abstract

Empiric antibiotic therapy — the administration of antibiotics before a microbiological diagnosis of infection is established — is a widely-used, but unproven practice in contemporary intensive care units (ICUs). The perceived need for pre-emptive antibiotic therapy stems from factors unique to infection in the critically ill. Nosocomial infection is common, occurring in up to one third of all patients admitted to an ICU [1]. The diagnosis is challenging. Clinical manifestations are non-specific [2–5], culture data are unreliable because of concomitant antibiotic use [6], and the differentiation of colonization from invasive infection is notoriously difficult [7, 8]. Infecting organisms are commonly resistant to first-line antibiotics [9, 10]. ICU-acquired infections develop in the sickest patients, for whom maximal therapeutic intervention is the norm, and clinicians are frequently reluctant to stop therapy, even when cultures are negative [11, 12].

Keywords

Nosocomial Infection Respir Crit Empiric Therapy Empiric Antibiotic Therapy Empiric Antibiotic 
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.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • M. A. Aarts
  • J. C. Marshall

There are no affiliations available

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