ICU · Antimicrobial therapy

Antimicrobial Therapy and Stewardship in the ICU

Also known as Antibiotic stewardship · Antimicrobial therapy · PK PD dosing · De-escalation · Antibiogram · Therapeutic drug monitoring · Antibiotic resistance

Antimicrobial stewardship is the systematic, the evidence-based, the measured use of the antibiotics to maximise the patient outcome, minimise the resistance, and reduce the toxicity. This topic builds the examiner's framework on the PK/PD dosing principles (the beta-lactam prolonged infusion, the aminoglycoside once-daily, the vancomycin AUC), the empirical therapy guided by the local antibiogram, the de-escalation when the culture returns, the duration of therapy (the shortest effective course), the beta-lactam allergy, the therapeutic drug monitoring, and the resistance mechanisms (the ESBL, the CRE, the MRSA, the VRE).