Skip to main content
Top
Published in: Intensive Care Medicine 11/2020

01-11-2020 | Antibiotic | Less is more in Intensive Care

Less is more: critically ill status is not a carte blanche for unlimited antibiotic use

Authors: Andre C. Kalil, Jean-Francois Timsit

Published in: Intensive Care Medicine | Issue 11/2020

Login to get access

Excerpt

The film “Blade Runner 2049” depicts a bleak view of humanity 30 years from now, a world in which survival will be much more difficult than today. You may say we are lucky that it is only 2020; however, we are already facing a growing and unstoppable shortage of antibiotics worldwide due to bacterial resistance, and this could end up in a humanitarian disaster. The CDC recently reported that the pace of antibiotic-resistant infections and its associated mortality are on the rise [1]. …
Appendix
Available only for authorised users
Literature
1.
go back to reference Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2019. Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2019.
2.
go back to reference Chatterjee A, Modarai M, Naylor NR, Boyd SE, Atun R, Barlow J, Holmes AH, Johnson A, Robotham JV (2018) Quantifying drivers of antibiotic resistance in humans: a systematic review. Lancet Infect Dis 18:e368–e378CrossRefPubMed Chatterjee A, Modarai M, Naylor NR, Boyd SE, Atun R, Barlow J, Holmes AH, Johnson A, Robotham JV (2018) Quantifying drivers of antibiotic resistance in humans: a systematic review. Lancet Infect Dis 18:e368–e378CrossRefPubMed
3.
go back to reference Versporten A, Zarb P, Caniaux I, Gros MF, Drapier N, Miller M, Jarlier V, Nathwani D, Goossens H, Global PPSn (2018) Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey. Lancet Glob Health 6:e619–e629CrossRefPubMed Versporten A, Zarb P, Caniaux I, Gros MF, Drapier N, Miller M, Jarlier V, Nathwani D, Goossens H, Global PPSn (2018) Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: results of an internet-based global point prevalence survey. Lancet Glob Health 6:e619–e629CrossRefPubMed
4.
go back to reference Timsit JF, Bassetti M, Cremer O, Daikos G, de Waele J, Kallil A, Kipnis E, Kollef M, Laupland K, Paiva JA, Rodriguez-Bano J, Ruppe E, Salluh J, Taccone FS, Weiss E, Barbier F (2019) Rationalizing antimicrobial therapy in the ICU: a narrative review. Intensive Care Med 45:172–189CrossRefPubMed Timsit JF, Bassetti M, Cremer O, Daikos G, de Waele J, Kallil A, Kipnis E, Kollef M, Laupland K, Paiva JA, Rodriguez-Bano J, Ruppe E, Salluh J, Taccone FS, Weiss E, Barbier F (2019) Rationalizing antimicrobial therapy in the ICU: a narrative review. Intensive Care Med 45:172–189CrossRefPubMed
5.
go back to reference De Waele JJ, Akova M, Antonelli M, Canton R, Carlet J, De Backer D, Dimopoulos G, Garnacho-Montero J, Kesecioglu J, Lipman J, Mer M, Paiva JA, Poljak M, Roberts JA, Rodriguez Bano J, Timsit JF, Zahar JR, Bassetti M (2018) Antimicrobial resistance and antibiotic stewardship programs in the ICU: insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi-drug resistance. Intensive Care Med 44:189–196CrossRefPubMed De Waele JJ, Akova M, Antonelli M, Canton R, Carlet J, De Backer D, Dimopoulos G, Garnacho-Montero J, Kesecioglu J, Lipman J, Mer M, Paiva JA, Poljak M, Roberts JA, Rodriguez Bano J, Timsit JF, Zahar JR, Bassetti M (2018) Antimicrobial resistance and antibiotic stewardship programs in the ICU: insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi-drug resistance. Intensive Care Med 44:189–196CrossRefPubMed
6.
go back to reference Bouadma L, Sonneville R, Garrouste-Orgeas M, Darmon M, Souweine B, Voiriot G, Kallel H, Schwebel C, Goldgran-Toledano D, Dumenil AS, Argaud L, Ruckly S, Jamali S, Planquette B, Adrie C, Lucet JC, Azoulay E, Timsit JF, Group OS (2015) Ventilator-associated events: prevalence, outcome, and relationship with ventilator-associated pneumonia. Crit Care Med 43:1798–1806CrossRefPubMed Bouadma L, Sonneville R, Garrouste-Orgeas M, Darmon M, Souweine B, Voiriot G, Kallel H, Schwebel C, Goldgran-Toledano D, Dumenil AS, Argaud L, Ruckly S, Jamali S, Planquette B, Adrie C, Lucet JC, Azoulay E, Timsit JF, Group OS (2015) Ventilator-associated events: prevalence, outcome, and relationship with ventilator-associated pneumonia. Crit Care Med 43:1798–1806CrossRefPubMed
7.
go back to reference Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, Napolitano LM, O'Grady NP, Bartlett JG, Carratala J, El Solh AA, Ewig S, Fey PD, File TM Jr, Restrepo MI, Roberts JA, Waterer GW, Cruse P, Knight SL, Brozek JL (2016) Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 63:e61–e111CrossRefPubMedPubMedCentral Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, Napolitano LM, O'Grady NP, Bartlett JG, Carratala J, El Solh AA, Ewig S, Fey PD, File TM Jr, Restrepo MI, Roberts JA, Waterer GW, Cruse P, Knight SL, Brozek JL (2016) Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 63:e61–e111CrossRefPubMedPubMedCentral
8.
go back to reference Tabah A, Bassetti M, Kollef MH, Zahar JR, Paiva JA, Timsit JF, Roberts JA, Schouten J, Giamarellou H, Rello J, De Waele J, Shorr AF, Leone M, Poulakou G, Depuydt P, Garnacho-Montero J (2019) Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP). Intensive Care Med 46(2):245–265. https://doi.org/10.1007/s00134-019-05866-wCrossRefPubMed Tabah A, Bassetti M, Kollef MH, Zahar JR, Paiva JA, Timsit JF, Roberts JA, Schouten J, Giamarellou H, Rello J, De Waele J, Shorr AF, Leone M, Poulakou G, Depuydt P, Garnacho-Montero J (2019) Antimicrobial de-escalation in critically ill patients: a position statement from a task force of the European Society of Intensive Care Medicine (ESICM) and European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Critically Ill Patients Study Group (ESGCIP). Intensive Care Med 46(2):245–265. https://​doi.​org/​10.​1007/​s00134-019-05866-wCrossRefPubMed
9.
go back to reference Roberts JA, Abdul-Aziz MH, Davis JS, Dulhunty JM, Cotta MO, Myburgh J, Bellomo R, Lipman J (2016) Continuous versus intermittent beta-lactam infusion in severe sepsis. a meta-analysis of individual patient data from randomized trials. Am J Respir Crit Care Med 194:681–691CrossRefPubMed Roberts JA, Abdul-Aziz MH, Davis JS, Dulhunty JM, Cotta MO, Myburgh J, Bellomo R, Lipman J (2016) Continuous versus intermittent beta-lactam infusion in severe sepsis. a meta-analysis of individual patient data from randomized trials. Am J Respir Crit Care Med 194:681–691CrossRefPubMed
10.
go back to reference Vardakas KZ, Voulgaris GL, Maliaros A, Samonis G, Falagas ME (2018) Prolonged versus short-term intravenous infusion of antipseudomonal beta-lactams for patients with sepsis: a systematic review and meta-analysis of randomised trials. Lancet Infect Dis 18:108–120CrossRefPubMed Vardakas KZ, Voulgaris GL, Maliaros A, Samonis G, Falagas ME (2018) Prolonged versus short-term intravenous infusion of antipseudomonal beta-lactams for patients with sepsis: a systematic review and meta-analysis of randomised trials. Lancet Infect Dis 18:108–120CrossRefPubMed
11.
go back to reference El Moussaoui R, Roede BM, Speelman P, Bresser P, Prins JM, Bossuyt PM (2008) Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax 63:415–422CrossRefPubMed El Moussaoui R, Roede BM, Speelman P, Bresser P, Prins JM, Bossuyt PM (2008) Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax 63:415–422CrossRefPubMed
12.
go back to reference Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG (2019) Diagnosis and treatment of adults with community-acquired pneumonia. an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 200:e45–e67CrossRefPubMedPubMedCentral Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG (2019) Diagnosis and treatment of adults with community-acquired pneumonia. an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 200:e45–e67CrossRefPubMedPubMedCentral
13.
go back to reference Kalil AC (2017) Antibiotic combination therapy for patients with gram-negative septic shock. Crit Care Med 45:1933–1936CrossRefPubMed Kalil AC (2017) Antibiotic combination therapy for patients with gram-negative septic shock. Crit Care Med 45:1933–1936CrossRefPubMed
14.
go back to reference Ong DSY, Frencken JF, Klein Klouwenberg PMC, Juffermans N, van der Poll T, Bonten MJM, Cremer OL, Consortium M (2017) Short-course adjunctive gentamicin as empirical therapy in patients with severe sepsis and septic shock: a prospective observational cohort study. Clin Infect Dis 64:1731–1736CrossRefPubMed Ong DSY, Frencken JF, Klein Klouwenberg PMC, Juffermans N, van der Poll T, Bonten MJM, Cremer OL, Consortium M (2017) Short-course adjunctive gentamicin as empirical therapy in patients with severe sepsis and septic shock: a prospective observational cohort study. Clin Infect Dis 64:1731–1736CrossRefPubMed
15.
go back to reference Brunkhorst FM, Oppert M, Marx G, Bloos F, Ludewig K, Putensen C, Nierhaus A, Jaschinski U, Meier-Hellmann A, Weyland A, Grundling M, Moerer O, Riessen R, Seibel A, Ragaller M, Buchler MW, John S, Bach F, Spies C, Reill L, Fritz H, Kiehntopf M, Kuhnt E, Bogatsch H, Engel C, Loeffler M, Kollef MH, Reinhart K, Welte T, German Study Group Competence Network S (2012) Effect of empirical treatment with moxifloxacin and meropenem vs meropenem on sepsis-related organ dysfunction in patients with severe sepsis: a randomized trial. JAMA 307:2390–2399CrossRefPubMed Brunkhorst FM, Oppert M, Marx G, Bloos F, Ludewig K, Putensen C, Nierhaus A, Jaschinski U, Meier-Hellmann A, Weyland A, Grundling M, Moerer O, Riessen R, Seibel A, Ragaller M, Buchler MW, John S, Bach F, Spies C, Reill L, Fritz H, Kiehntopf M, Kuhnt E, Bogatsch H, Engel C, Loeffler M, Kollef MH, Reinhart K, Welte T, German Study Group Competence Network S (2012) Effect of empirical treatment with moxifloxacin and meropenem vs meropenem on sepsis-related organ dysfunction in patients with severe sepsis: a randomized trial. JAMA 307:2390–2399CrossRefPubMed
16.
go back to reference Bliziotis IA, Samonis G, Vardakas KZ, Chrysanthopoulou S, Falagas ME (2005) Effect of aminoglycoside and beta-lactam combination therapy versus beta-lactam monotherapy on the emergence of antimicrobial resistance: a meta-analysis of randomized, controlled trials. Clin Infect Dis 41:149–158CrossRefPubMed Bliziotis IA, Samonis G, Vardakas KZ, Chrysanthopoulou S, Falagas ME (2005) Effect of aminoglycoside and beta-lactam combination therapy versus beta-lactam monotherapy on the emergence of antimicrobial resistance: a meta-analysis of randomized, controlled trials. Clin Infect Dis 41:149–158CrossRefPubMed
17.
go back to reference Vaughn VM, Flanders SA, Snyder A, Conlon A, Rogers MAM, Malani AN, McLaughlin E, Bloemers S, Srinivasan A, Nagel J, Kaatz S, Osterholzer D, Thyagarajan R, Hsaiky L, Chopra V, Gandhi TN (2019) Excess antibiotic treatment duration and adverse events in patients hospitalized with pneumonia: a multihospital cohort study. Ann Intern Med 171:153–163CrossRefPubMed Vaughn VM, Flanders SA, Snyder A, Conlon A, Rogers MAM, Malani AN, McLaughlin E, Bloemers S, Srinivasan A, Nagel J, Kaatz S, Osterholzer D, Thyagarajan R, Hsaiky L, Chopra V, Gandhi TN (2019) Excess antibiotic treatment duration and adverse events in patients hospitalized with pneumonia: a multihospital cohort study. Ann Intern Med 171:153–163CrossRefPubMed
18.
go back to reference Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL (2000) Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med 162:505–511CrossRefPubMed Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL (2000) Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med 162:505–511CrossRefPubMed
19.
go back to reference Chastre J, Wolff M, Fagon JY, Chevret S, Thomas F, Wermert D, Clementi E, Gonzalez J, Jusserand D, Asfar P, Perrin D, Fieux F, Aubas S, Pneum ATG (2003) Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA 290:2588–2598CrossRefPubMed Chastre J, Wolff M, Fagon JY, Chevret S, Thomas F, Wermert D, Clementi E, Gonzalez J, Jusserand D, Asfar P, Perrin D, Fieux F, Aubas S, Pneum ATG (2003) Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA 290:2588–2598CrossRefPubMed
Metadata
Title
Less is more: critically ill status is not a carte blanche for unlimited antibiotic use
Authors
Andre C. Kalil
Jean-Francois Timsit
Publication date
01-11-2020
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 11/2020
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-020-06260-7

Other articles of this Issue 11/2020

Intensive Care Medicine 11/2020 Go to the issue