Empirical Antibiotic Treatment in ICU Patients

  • P. Grossi
Conference paper


The increasing resistance of more and more bacteria to the antibiotics originally designed to treat them has created a unique challenge for the medical profession and the pharmaceuticals industry.


Nosocomial Infection Antimicrob Agent Intermittent Infusion Empirical Antibiotic Treatment Infect Control Hosp 
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  1. 1.
    Kollef MH, Sherman G, Ward S, Fraser VJ (1999) Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest 115: 462–474PubMedCrossRefGoogle Scholar
  2. 2.
    Dupont H, Mentec H, Sollet JP, Bleichner G (2001) Impact of appropriateness of initial antibiotic therapy on the outcome of ventilator associated pneumonia. Intensive Care Med 27: 355–362PubMedCrossRefGoogle Scholar
  3. 3.
    Ibrahim EH, Sherman G, Ward S, et al (2000) The influence of inadequate antimicrobial treatment of bloodstream infections on patients outcome in the ICU setting. Chest 118: 146–155PubMedCrossRefGoogle Scholar
  4. 4.
    Handwerger S, Raucher B, Altarac D, et al (1993) Nosocomial outbreak due to Enterococcus faecium highly resistant to vancomycin, penicillin and gentamicin. Clin Infect Dis 16: 750–755PubMedCrossRefGoogle Scholar
  5. 5.
    Nosocomial enterococci resistant to vancomycin-United States, 1989–1993 (1993) MMWR 42: 597–599Google Scholar
  6. 6.
    Iwen PC, Kelly DM, Linder J, et al (1997) Change in prevalence and antibiotic resistance of Enterococcus species isolated from blood cultures over an 8-year period. Antimicrob Agents Chemother 41: 494–495PubMedGoogle Scholar
  7. 7.
    Murray BE (2000) Vancomycin-resistant enterococcal infections. N Engl J Med 342: 710–721PubMedCrossRefGoogle Scholar
  8. 8.
    Hiramatsu K, Hanaki H, Ino T, et al (1997) Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemother 40: 135–136PubMedCrossRefGoogle Scholar
  9. 9.
    Hiramatsu K, Aritaka N, Hanaki H, et al (1997) Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin. Lancet 350: 1670–1673PubMedCrossRefGoogle Scholar
  10. 10.
    Rotun SS, McMath V, Schoonmaker DJ, et al (1999) Staphylococcus aureus with reduced susceptibility to vancomycin isolated from a patient with fatal bacteremia. Emerg Infect Dis 5: 147–149PubMedCrossRefGoogle Scholar
  11. 11.
    Edmond MB, Wallace SE, McClish DK, et al (1999) Nosocomial bloodstream infections in the United States hospitals: a three-year analysis. Clin Infect Dis 29: 239–244PubMedCrossRefGoogle Scholar
  12. 12.
    Vincent J-L, Bihari DJ, Suter PM, et al (1995) The prevalence of nosocomial infection in intensive care units in Europe. JAMA 274: 639–644Google Scholar
  13. 13.
    Fluit AC, Jones ME, Schmidt F-J, et al SENTRY Participants Group (2000) Antimicrobial susceptibility and frequency of occurrence of clinical blood isolates in Europe from the SENTRY antimicrobial surveillance program, 1997 and 1998. Clin Infect Dis 30: 454–460Google Scholar
  14. 14.
    Flournoy DJ, Reinert RL, Bell-Dixon C, Gentry CA (2000) Increasing antimicrobial resistance in gram-negative bacilli isolated from patients in intensive care units. Infect Control Hosp Epidemiol 28: 244–250Google Scholar
  15. 15.
    Wu LC, Brook JH (2000) Multiple antibiotic resistant bacteria in New Jersey hospitals, 1992–1.998 (abstract). International Conference on Emerging Infectious Diseases. Atlanta, Georgia, USA, July 16–19, 2000. Centers for Disease Control and Prevention, Georgia, p 75Google Scholar
  16. 16.
    Centers for Disease Control and Prevention (2000) Laboratory capacity to detect antimicrobial resistance, 1998. MMWR Morb Mortal Wkly Report 48: 1167–1171Google Scholar
  17. 17.
    Garner JS, Hospital Infection Control Practices Advisory Committee (1996) Guideline for isolation precautions in hospitals. I. Evolution of isolation practices. Am J Infect Control 24: 24–31Google Scholar
  18. 18.
    Larson EL, APIC Guidelines Committee (1995) APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 23: 251–269CrossRefGoogle Scholar
  19. 19.
    Hospital Infection Control Practice Advisory Committee (HICPAC) (1995) Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol 16: 105–113CrossRefGoogle Scholar
  20. 20.
    Quale J, Landman D, Atwood E, et al (1996) Experience with a hospital-wide outbreak of vancomycin-resistant enterococci. Am J Infect Control 24: 372–379PubMedCrossRefGoogle Scholar
  21. 21.
    Moulin F, Dumontier S, Saulnier P (1996) Surveillance of intestinal colonization and of infection by vancomycin-resistant enterococci in hospitalized cancer patients. Clin Microbiol Infect 34: 751–752Google Scholar
  22. 22.
    Bradley SJ, Wilson ALT, Allen MC, et al (1999) The control of hyperendemic glycopeptide-resistant Enterococcus spp. on a haematology unit by changing antibiotic usage. J Antimicrob Chemother 43: 261–266PubMedCrossRefGoogle Scholar
  23. 23.
    Wenzel RP, Reagan DR, Bertino JS, et al (1998) Methicillin-resistant Staphylococcus aureus outbreak: a consensus panel’s definition and management guidelines. Am J Infect Control 26: 102–110PubMedCrossRefGoogle Scholar
  24. 24.
    CDC interim guidelines for prevention and control of staphylococcal infections associated with reduced susceptibility to vancomycin. (2000) MMWR 48: 1167–1171Google Scholar
  25. 25.
    James JK, Palmer SM, Levine DP, Rybak MJ (1999) Comparison of conventional dosing versus continuous infusion vancomycin therapy for patients with suspected or documented Gram positive infections. Antimicrob Agents Chemother 40: 696–700Google Scholar
  26. 26.
    Climo M, Patron RL, Archer G (1999) Combinations of vancomycin and beta-lactams are synergistic in the treatment of vancomycin intermediate susceptible S.aureus Antimicrob Agents Chemother 43 (7): 1747–1753Google Scholar
  27. 27.
    Cercenado E, Eliopoulos GM, Wennerstern CB, Moellering RC Jr. (1992) Absence of synergistic activity between ampicillin and vancomycin against highly vancomycin-resistant enterococci. Antimicrob Agents Chemother 36: 2201–2203PubMedGoogle Scholar
  28. 28.
    Fridkin SK, Welbel SF, Weinstein RA (1996) Magnitude and prevention of nosocomial infections in the intensive care unit. Infect Dis Clin North Am 11: 479–496CrossRefGoogle Scholar
  29. 29.
    Rice LB, Eckstein EC, DeVente J, et al (1996) Ceftazidime-resistant Klebsiella pneumoniae isolates recovered at the Cleveland Department of Veterans Affairs Medical Center. Clin Infect Dis 23: 118–124PubMedCrossRefGoogle Scholar
  30. 30.
    Karas JA, Pillay DG, Muckart D, et al (1996) Treatment failure due to extended spectrum (3-lactamase. J Antimicrob Chemother 37: 203PubMedCrossRefGoogle Scholar
  31. 31.
    Jacoby GA, Han P. (1996) Detection of extended-spectrum 3-lactamases in clinical isolates of Klebsiella pneumoniae and Escherichia coli. J Clin Microbiol 34: 908–911PubMedGoogle Scholar
  32. 32.
    Burwen DR, Banerjee SN, Gaynes RP, et al (1994) Ceftazidime resistance among selected nosocomial gram-negative bacilli in the United States, J Infect Dis 170: 1622–1625PubMedCrossRefGoogle Scholar
  33. 33.
    Piroth L, Aube H, Doise J, et al (1998) Spread of extended-spectrum-lactamase—producing Klebsiella pneumoniae: are (3-lactamase inhibitors of therapeutic value? Clin Infect Dis 27: 76–80PubMedCrossRefGoogle Scholar
  34. 34.
    Schiappa DA, Hayden MK, Matushek MG, et al (1996) Ceftazidime-resistant Klebsiella pneumoniae and Escherichia coli bloodstream infection: a case-control and molecular epidemiologic investigation. J Infect Dis 174: 529–536PubMedCrossRefGoogle Scholar
  35. 35.
    Monnet D, Biddle JW, Edwards JR, et al (1997) Evidence of interhospital transmission of extended-spectrum-lactam—resistant Klebisella pneumoniae in the United States, 1986–1993. Infect Control Hosp Epidemiol 18: 492–498PubMedCrossRefGoogle Scholar
  36. 36.
    Rex JH, Pfaller MA, Rinaldi MG, et al (1993) Antifungal susceptibility testing. Clin Microbiol Rev 6: 367–381PubMedGoogle Scholar
  37. 37.
    McCaig LF, Hughes JM (1995) Trends in antimicrobial drug prescribing among office-based physicians in the United States. JAMA 273: 214–219Google Scholar
  38. 38.
    Johnson EM, Warnock DW, Luker J, et al (1995) Emergence of azole drug resistance in Candida species from HIV-infected patients receiving prolonged fluconazole therapy for oral candidosis. J Antimicrob Chemother 35:103–114 -°Google Scholar
  39. 39.
    Maenza JR, Keruly JC, Moore RD, et al (1996) Risk factors for fluconazole-resistant candidiasis in human immunodeficiencyvirus-infected patients. J Infect Dis 173: 219–225PubMedCrossRefGoogle Scholar
  40. 40.
    Abi-Said D, Anaissie E, Uzon O, et al (1997) The epidemiology of hematogenous candidiasis caused by different Candida species. Clin Infect Dis 24: 1122–1128PubMedCrossRefGoogle Scholar
  41. 41.
    Fridkin SK, Jarvis WR (1996) Epidemiology of nosocomial fungal infections. Clin Microbiol Rev 9: 499–511PubMedGoogle Scholar
  42. 42.
    Pfaller MA, Jones RN, Messer SA, et al (1998) National surveillance of nosocomial blood stream infection due to Candida albicans: frequency of occurrence and antifungal susceptibility in the SCOPE Program. Diagn Microbiol Infect Dis 31: 327–332PubMedCrossRefGoogle Scholar
  43. 43.
    World Health Organization. (2000) Overcoming Antimicrobial Resistance - World Health Report on Infectious Diseases 2000. Available at http://www.who.int/infectious-disease-report/2000/index.html. World Health Organization, GenevaGoogle Scholar
  44. 44.
    Interagency Task Force on Antimicrobial Resistance (2000) Draft public health action plan to combat antimicrobial resistance. I Domestic issues. Available at website: http://www.cdc.gov/drugresistance/actionplan/index.htm Atlanta. Centers for Disease Control and PreventionGoogle Scholar
  45. 45.
    Association for the Prudent Use of Antibiotics. (2000) Response to the Draft Public Health Action Plan on Antimicrobial Resistance. Available at APUA website: http://www.healthsci.tufts.edu/apua/apua.html Google Scholar
  46. 46.
    Goldmann DA, Weinstein RA, Wenzel RP, et al (1996) Strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in hospitals. JAMA 275: 234–240Google Scholar

Copyright information

© Springer-Verlag Italia, Milano 2002

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  • P. Grossi

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