Skip to main content
Top
Published in: Critical Care 1/2010

01-02-2010 | Review

Pro/con debate: Should antimicrobial stewardship programs be adopted universally in the intensive care unit?

Authors: Philip George, Andrew M Morris

Published in: Critical Care | Issue 1/2010

Login to get access

Abstract

You are director of a large multi-disciplinary ICU. You have recently read that hospital-wide antibiotic stewardship programs have the potential to improve the quality and safety of care, and to reduce the emergence of multi-drug resistant organisms and overall costs. You are considering starting one of these programs in your ICU, but are concerned about the associated infrastructure costs. You are debating whether it is worth bringing the concept forward to your hospital's administration to consider investing in.
Literature
1.
go back to reference Dellit TH, Owens RC, McGowan JE Jr, Gerding DN, Weinstein RA, Burke JP, Huskins WC, Paterson DL, Fishman NO, Carpenter CF, Brennan PJ, Billeter M, Hooton TM, Infectious Diseases Society of America; Society for Healthcare Epidemiology of America: Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007, 44: 159-177. 10.1086/510393CrossRefPubMed Dellit TH, Owens RC, McGowan JE Jr, Gerding DN, Weinstein RA, Burke JP, Huskins WC, Paterson DL, Fishman NO, Carpenter CF, Brennan PJ, Billeter M, Hooton TM, Infectious Diseases Society of America; Society for Healthcare Epidemiology of America: Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007, 44: 159-177. 10.1086/510393CrossRefPubMed
2.
go back to reference Gerding DN: The search for good antimicrobial stewardship. Jt Comm J Qual Improv 2001, 27: 403-404.PubMed Gerding DN: The search for good antimicrobial stewardship. Jt Comm J Qual Improv 2001, 27: 403-404.PubMed
3.
go back to reference Marr JJ, Moffet HL, Kunin CM: Guidelines for improving the use of antimicrobial agents in hospitals: A statement by the Infectious Diseases Society of America. J Infect Dis 1988, 157: 869-876.CrossRefPubMed Marr JJ, Moffet HL, Kunin CM: Guidelines for improving the use of antimicrobial agents in hospitals: A statement by the Infectious Diseases Society of America. J Infect Dis 1988, 157: 869-876.CrossRefPubMed
4.
go back to reference Gonzales R, Malone DC, Maselli JH, Sande MA: Excessive antibiotic use for acute respiratory infections in the United States. Clin Infect Dis 2001, 33: 757-762. 10.1086/322627CrossRefPubMed Gonzales R, Malone DC, Maselli JH, Sande MA: Excessive antibiotic use for acute respiratory infections in the United States. Clin Infect Dis 2001, 33: 757-762. 10.1086/322627CrossRefPubMed
5.
go back to reference Marra AR, Edmond MB, Wenzel RP, Bearman GM: Hospital-acquired Clostridium difficile -associated disease in the intensive care unit setting: Epidemiology, clinical course and outcome. BMC Infect Dis 2007, 7: 42. 10.1186/1471-2334-7-42PubMedCentralCrossRefPubMed Marra AR, Edmond MB, Wenzel RP, Bearman GM: Hospital-acquired Clostridium difficile -associated disease in the intensive care unit setting: Epidemiology, clinical course and outcome. BMC Infect Dis 2007, 7: 42. 10.1186/1471-2334-7-42PubMedCentralCrossRefPubMed
6.
go back to reference Chen DK, McGeer A, de Azavedo JC, Low DE: Decreased susceptibility of Streptococcus pneumoniae to fluoroquinolones in Canada. Canadian Bacterial Surveillance Network. N Engl J Med 1999, 341: 233-239. 10.1056/NEJM199907223410403CrossRefPubMed Chen DK, McGeer A, de Azavedo JC, Low DE: Decreased susceptibility of Streptococcus pneumoniae to fluoroquinolones in Canada. Canadian Bacterial Surveillance Network. N Engl J Med 1999, 341: 233-239. 10.1056/NEJM199907223410403CrossRefPubMed
7.
go back to reference Dinubile MJ, Friedland I, Chan CY, Motyl MR, Giezek H, Shivaprakash M, Weinstein RA, Quinn JP: Bowel colonization with resistant gram-negative bacilli after antimicrobial therapy of intra-abdominal infections: Observations from two randomized comparative clinical trials of ertapenem therapy. Eur J Clin Microbiol Infect Dis 2005, 24: 443-449. 10.1007/s10096-005-1356-0CrossRefPubMed Dinubile MJ, Friedland I, Chan CY, Motyl MR, Giezek H, Shivaprakash M, Weinstein RA, Quinn JP: Bowel colonization with resistant gram-negative bacilli after antimicrobial therapy of intra-abdominal infections: Observations from two randomized comparative clinical trials of ertapenem therapy. Eur J Clin Microbiol Infect Dis 2005, 24: 443-449. 10.1007/s10096-005-1356-0CrossRefPubMed
8.
go back to reference Owens RC Jr, Rice L: Hospital-based strategies for combating resistance. Clin Infect Dis 2006,42(Suppl 4):S173-181. 10.1086/500664CrossRefPubMed Owens RC Jr, Rice L: Hospital-based strategies for combating resistance. Clin Infect Dis 2006,42(Suppl 4):S173-181. 10.1086/500664CrossRefPubMed
9.
go back to reference Deplano A, Denis O, Poirel L, Hocquet D, Nonhoff C, Byl B, Nordmann P, Vincent JL, Struelens MJ: Molecular characterization of an epidemic clone of panantibiotic-resistant Pseudomonas aeruginosa . J Clin Microbiol 2005, 43: 1198-1204. 10.1128/JCM.43.3.1198-1204.2005PubMedCentralCrossRefPubMed Deplano A, Denis O, Poirel L, Hocquet D, Nonhoff C, Byl B, Nordmann P, Vincent JL, Struelens MJ: Molecular characterization of an epidemic clone of panantibiotic-resistant Pseudomonas aeruginosa . J Clin Microbiol 2005, 43: 1198-1204. 10.1128/JCM.43.3.1198-1204.2005PubMedCentralCrossRefPubMed
10.
go back to reference D'Arezzo S, Capone A, Petrosillo N, Visca P, GRAB, Ballardini M, Bartolini S, Bordi E, Di Stefano A, Galiè M, Minniti R, Meledandri M, Pacciani L, Parisi G, Prignano G, Santini C, Valmarin M, Venditti M, Ziantoni S: Epidemic multidrug-resistant Acinetobacter baumannii related to European clonal types I and II in Rome (Italy). Clin Microbiol Infect 2009, 15: 347-357. 10.1111/j.1469-0691.2009.02668.xCrossRefPubMed D'Arezzo S, Capone A, Petrosillo N, Visca P, GRAB, Ballardini M, Bartolini S, Bordi E, Di Stefano A, Galiè M, Minniti R, Meledandri M, Pacciani L, Parisi G, Prignano G, Santini C, Valmarin M, Venditti M, Ziantoni S: Epidemic multidrug-resistant Acinetobacter baumannii related to European clonal types I and II in Rome (Italy). Clin Microbiol Infect 2009, 15: 347-357. 10.1111/j.1469-0691.2009.02668.xCrossRefPubMed
11.
go back to reference Falagas ME, Kopterides P: Risk factors for the isolation of multi-drug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa : A systematic review of the literature. J Hosp Infect 2006, 64: 7-15. 10.1016/j.jhin.2006.04.015CrossRefPubMed Falagas ME, Kopterides P: Risk factors for the isolation of multi-drug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa : A systematic review of the literature. J Hosp Infect 2006, 64: 7-15. 10.1016/j.jhin.2006.04.015CrossRefPubMed
12.
go back to reference Owens RC: Clostridium difficile -associated disease: An emerging threat to patient safety: Insights from the Society of Infectious Diseases Pharmacists. Pharmacotherapy 2006, 26: 299-311. 10.1592/phco.26.3.299CrossRefPubMed Owens RC: Clostridium difficile -associated disease: An emerging threat to patient safety: Insights from the Society of Infectious Diseases Pharmacists. Pharmacotherapy 2006, 26: 299-311. 10.1592/phco.26.3.299CrossRefPubMed
13.
go back to reference Zhanel GG, Decorby M, Nichol KA, Baudry PJ, Karlowsky JA, Lagace-Wiens PR, McCracken M, Mulvey MR, Hoban DJ: Characterization of methicillinresistant Staphylococcus aureus , vancomycin-resistant enterococci and extended-spectrum beta-lactamase-producing Escherichia coli in intensive care units in Canada: Results of the Canadian National Intensive Care Unit (Can-ICU) Study (2005-2006). Can J Infect Dis Med Microbiol 2008, 19: 243-249.PubMedCentralPubMed Zhanel GG, Decorby M, Nichol KA, Baudry PJ, Karlowsky JA, Lagace-Wiens PR, McCracken M, Mulvey MR, Hoban DJ: Characterization of methicillinresistant Staphylococcus aureus , vancomycin-resistant enterococci and extended-spectrum beta-lactamase-producing Escherichia coli in intensive care units in Canada: Results of the Canadian National Intensive Care Unit (Can-ICU) Study (2005-2006). Can J Infect Dis Med Microbiol 2008, 19: 243-249.PubMedCentralPubMed
14.
go back to reference Charles PE, Dalle F, Aube H, Doise JM, Quenot JP, Aho LS, Chavanet P, Blettery B: Candida spp. Colonization significance in critically ill medical patients: A prospective study. Intensive Care Med 2005, 31: 393-400. 10.1007/s00134-005-2571-yCrossRefPubMed Charles PE, Dalle F, Aube H, Doise JM, Quenot JP, Aho LS, Chavanet P, Blettery B: Candida spp. Colonization significance in critically ill medical patients: A prospective study. Intensive Care Med 2005, 31: 393-400. 10.1007/s00134-005-2571-yCrossRefPubMed
16.
go back to reference Roberts RR, Hota B, Ahmad I, Scott RD, Foster SD, Abbasi F, Schabowski S, Kampe LM, Ciavarella GG, Supino M, Naples J, Cordell R, Levy SB, Weinstein RA: Hospital and societal costs of antimicrobial-resistant infections in a Chicago teaching hospital: implications for antibiotic stewardship. Clin Infect Dis 2009, 49: 1175-1184. 10.1086/605630CrossRefPubMed Roberts RR, Hota B, Ahmad I, Scott RD, Foster SD, Abbasi F, Schabowski S, Kampe LM, Ciavarella GG, Supino M, Naples J, Cordell R, Levy SB, Weinstein RA: Hospital and societal costs of antimicrobial-resistant infections in a Chicago teaching hospital: implications for antibiotic stewardship. Clin Infect Dis 2009, 49: 1175-1184. 10.1086/605630CrossRefPubMed
17.
go back to reference Hoffman JM, Shah ND, Vermeulen LC, Doloresco F, Martin PK, Blake S, Matusiak L, Hunkler RJ, Schumock GT: Projecting future drug expenditures - 2009. Am J Health Syst Pharm 2009, 66: 237-257. 10.2146/ajhp080636CrossRefPubMed Hoffman JM, Shah ND, Vermeulen LC, Doloresco F, Martin PK, Blake S, Matusiak L, Hunkler RJ, Schumock GT: Projecting future drug expenditures - 2009. Am J Health Syst Pharm 2009, 66: 237-257. 10.2146/ajhp080636CrossRefPubMed
18.
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, PneumA Trial Group: Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: A randomized trial. JAMA 2003, 290: 2588-2598. 10.1001/jama.290.19.2588CrossRefPubMed 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, PneumA Trial Group: Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: A randomized trial. JAMA 2003, 290: 2588-2598. 10.1001/jama.290.19.2588CrossRefPubMed
19.
go back to reference Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL: 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 2000, 162: 505-511.CrossRefPubMed Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL: 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 2000, 162: 505-511.CrossRefPubMed
20.
go back to reference Owens RC Jr, Shorr AF, Deschambeault AL: Antimicrobial stewardship: Shepherding precious resources. Am J Health Syst Pharm 2009, 66: S15-22. 10.2146/090087cCrossRefPubMed Owens RC Jr, Shorr AF, Deschambeault AL: Antimicrobial stewardship: Shepherding precious resources. Am J Health Syst Pharm 2009, 66: S15-22. 10.2146/090087cCrossRefPubMed
21.
go back to reference John JF Jr, Fishman NO: Programmatic role of the infectious diseases physician in controlling antimicrobial costs in the hospital. Clin Infect Dis 1997, 24: 471-485.CrossRefPubMed John JF Jr, Fishman NO: Programmatic role of the infectious diseases physician in controlling antimicrobial costs in the hospital. Clin Infect Dis 1997, 24: 471-485.CrossRefPubMed
22.
go back to reference White AC Jr, Atmar RL, Wilson J, Cate TR, Stager CE, Greenberg SB: Effects of requiring prior authorization for selected antimicrobials: Expenditures, susceptibilities, and clinical outcomes. Clin Infect Dis 1997, 25: 230-239. 10.1086/514545CrossRefPubMed White AC Jr, Atmar RL, Wilson J, Cate TR, Stager CE, Greenberg SB: Effects of requiring prior authorization for selected antimicrobials: Expenditures, susceptibilities, and clinical outcomes. Clin Infect Dis 1997, 25: 230-239. 10.1086/514545CrossRefPubMed
23.
go back to reference Fraser GL, Stogsdill P, Dickens JD Jr, Wennberg DE, Smith RP Jr, Prato BS: Antibiotic optimization. An evaluation of patient safety and economic outcomes. Arch Intern Med 1997, 157: 1689-1694. 10.1001/archinte.157.15.1689CrossRefPubMed Fraser GL, Stogsdill P, Dickens JD Jr, Wennberg DE, Smith RP Jr, Prato BS: Antibiotic optimization. An evaluation of patient safety and economic outcomes. Arch Intern Med 1997, 157: 1689-1694. 10.1001/archinte.157.15.1689CrossRefPubMed
24.
go back to reference LaRocco A Jr: Concurrent antibiotic review programs--a role for infectious diseases specialists at small community hospitals. Clin Infect Dis 2003, 37: 742-743. 10.1086/377286CrossRefPubMed LaRocco A Jr: Concurrent antibiotic review programs--a role for infectious diseases specialists at small community hospitals. Clin Infect Dis 2003, 37: 742-743. 10.1086/377286CrossRefPubMed
25.
go back to reference Solomon DH, Van Houten L, Glynn RJ, Baden L, Curtis K, Schrager H, Avorn J: Academic detailing to improve use of broad-spectrum antibiotics at an academic medical center. Arch Intern Med 2001, 161: 1897-1902. 10.1001/archinte.161.15.1897CrossRefPubMed Solomon DH, Van Houten L, Glynn RJ, Baden L, Curtis K, Schrager H, Avorn J: Academic detailing to improve use of broad-spectrum antibiotics at an academic medical center. Arch Intern Med 2001, 161: 1897-1902. 10.1001/archinte.161.15.1897CrossRefPubMed
26.
go back to reference Carling P, Fung T, Killion A, Terrin N, Barza M: Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years. Infect Control Hosp Epidemiol 2003, 24: 699-706. 10.1086/502278CrossRefPubMed Carling P, Fung T, Killion A, Terrin N, Barza M: Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years. Infect Control Hosp Epidemiol 2003, 24: 699-706. 10.1086/502278CrossRefPubMed
27.
go back to reference Thursky KA, Buising KL, Bak N, Macgregor L, Street AC, Macintyre CR, Presneill JJ, Cade JF, Brown GV: Reduction of broad-spectrum antibiotic use with computerized decision support in an intensive care unit. Int J Qual Health Care 2006, 18: 224-231. 10.1093/intqhc/mzi095CrossRefPubMed Thursky KA, Buising KL, Bak N, Macgregor L, Street AC, Macintyre CR, Presneill JJ, Cade JF, Brown GV: Reduction of broad-spectrum antibiotic use with computerized decision support in an intensive care unit. Int J Qual Health Care 2006, 18: 224-231. 10.1093/intqhc/mzi095CrossRefPubMed
28.
go back to reference Bochicchio GV, Smit PA, Moore R, Bochicchio K, Auwaerter P, Johnson SB, Scalea T, Bartlett JG: Pilot study of a web-based antibiotic decision management guide. J Am Coll Surg 2006, 202: 459-467. 10.1016/j.jamcollsurg.2005.11.010CrossRefPubMed Bochicchio GV, Smit PA, Moore R, Bochicchio K, Auwaerter P, Johnson SB, Scalea T, Bartlett JG: Pilot study of a web-based antibiotic decision management guide. J Am Coll Surg 2006, 202: 459-467. 10.1016/j.jamcollsurg.2005.11.010CrossRefPubMed
29.
go back to reference Paul M, Nielsen AD, Goldberg E, Andreassen S, Tacconelli E, Almanasreh N, Frank U, Cauda R, Leibovici L: Prediction of specific pathogens in patients with sepsis: Evaluation of treat, a computerized decision support system. J Antimicrob Chemother 2007, 59: 1204-1207. 10.1093/jac/dkm107CrossRefPubMed Paul M, Nielsen AD, Goldberg E, Andreassen S, Tacconelli E, Almanasreh N, Frank U, Cauda R, Leibovici L: Prediction of specific pathogens in patients with sepsis: Evaluation of treat, a computerized decision support system. J Antimicrob Chemother 2007, 59: 1204-1207. 10.1093/jac/dkm107CrossRefPubMed
30.
go back to reference Evans RS, Larsen RA, Burke JP, Gardner RM, Meier FA, Jacobson JA, Conti MT, Jacobson JT, Hulse RK: Computer surveillance of hospital-acquired infections and antibiotic use. JAMA 1986, 256: 1007-1011. 10.1001/jama.256.8.1007CrossRefPubMed Evans RS, Larsen RA, Burke JP, Gardner RM, Meier FA, Jacobson JA, Conti MT, Jacobson JT, Hulse RK: Computer surveillance of hospital-acquired infections and antibiotic use. JAMA 1986, 256: 1007-1011. 10.1001/jama.256.8.1007CrossRefPubMed
31.
go back to reference Classen DC, Pestotnik SL, Evans RS, Burke JP: Computerized surveillance of adverse drug events in hospital patients. JAMA 1991, 266: 2847-2851. 10.1001/jama.266.20.2847CrossRefPubMed Classen DC, Pestotnik SL, Evans RS, Burke JP: Computerized surveillance of adverse drug events in hospital patients. JAMA 1991, 266: 2847-2851. 10.1001/jama.266.20.2847CrossRefPubMed
32.
go back to reference Richards MJ, Robertson MB, Dartnell JG, Duarte MM, Jones NR, Kerr DA, Lim LL, Ritchie PD, Stanton GJ, Taylor SE: Impact of a web-based antimicrobial approval system on broad-spectrum cephalosporin use at a teaching hospital. Med J Aust 2003, 178: 386-390.PubMed Richards MJ, Robertson MB, Dartnell JG, Duarte MM, Jones NR, Kerr DA, Lim LL, Ritchie PD, Stanton GJ, Taylor SE: Impact of a web-based antimicrobial approval system on broad-spectrum cephalosporin use at a teaching hospital. Med J Aust 2003, 178: 386-390.PubMed
33.
go back to reference Pestotnik SL, Classen DC, Evans RS, Burke JP: Implementing antibiotic practice guidelines through computer-assisted decision support: Clinical and financial outcomes. Ann Intern Med 1996, 124: 884-890.CrossRefPubMed Pestotnik SL, Classen DC, Evans RS, Burke JP: Implementing antibiotic practice guidelines through computer-assisted decision support: Clinical and financial outcomes. Ann Intern Med 1996, 124: 884-890.CrossRefPubMed
34.
go back to reference Micek ST, Roubinian N, Heuring T, Bode M, Williams J, Harrison C, Murphy T, Prentice D, Ruoff BE, Kollef MH: Before-after study of a standardized hospital order set for the management of septic shock. Crit Care Med 2006, 34: 2707-2713. 10.1097/01.CCM.0000241151.25426.D7CrossRefPubMed Micek ST, Roubinian N, Heuring T, Bode M, Williams J, Harrison C, Murphy T, Prentice D, Ruoff BE, Kollef MH: Before-after study of a standardized hospital order set for the management of septic shock. Crit Care Med 2006, 34: 2707-2713. 10.1097/01.CCM.0000241151.25426.D7CrossRefPubMed
35.
go back to reference Thiel SW, Asghar MF, Micek ST, Reichley RM, Doherty JA, Kollef MH: Hospital-wide impact of a standardized order set for the management of bacteremic severe sepsis. Crit Care Med 2009, 37: 819-824. 10.1097/CCM.0b013e318196206bCrossRefPubMed Thiel SW, Asghar MF, Micek ST, Reichley RM, Doherty JA, Kollef MH: Hospital-wide impact of a standardized order set for the management of bacteremic severe sepsis. Crit Care Med 2009, 37: 819-824. 10.1097/CCM.0b013e318196206bCrossRefPubMed
36.
go back to reference Zillich AJ, Sutherland JM, Wilson SJ, Diekema DJ, Ernst EJ, Vaughn TE, Doebbeling BN: Antimicrobial use control measures to prevent and control antimicrobial resistance in US hospitals. Infect Control Hosp Epidemiol 2006, 27: 1088-1095. 10.1086/507963CrossRefPubMed Zillich AJ, Sutherland JM, Wilson SJ, Diekema DJ, Ernst EJ, Vaughn TE, Doebbeling BN: Antimicrobial use control measures to prevent and control antimicrobial resistance in US hospitals. Infect Control Hosp Epidemiol 2006, 27: 1088-1095. 10.1086/507963CrossRefPubMed
37.
go back to reference Davey P, Brown E, Fenelon L, Finch R, Gould I, Hartman G, Holmes A, Ramsay C, Taylor E, Wilcox M, Wiffen P: Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2005, CD003543. Davey P, Brown E, Fenelon L, Finch R, Gould I, Hartman G, Holmes A, Ramsay C, Taylor E, Wilcox M, Wiffen P: Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2005, CD003543.
38.
go back to reference Dellit TH, Chan JD, Skerrett SJ, Nathens AB: Development of a guideline for the management of ventilator-associated pneumonia based on local microbiologic findings and impact of the guideline on antimicrobial use practices. Infect Control Hosp Epidemiol 2008, 29: 525-533. 10.1086/588160CrossRefPubMed Dellit TH, Chan JD, Skerrett SJ, Nathens AB: Development of a guideline for the management of ventilator-associated pneumonia based on local microbiologic findings and impact of the guideline on antimicrobial use practices. Infect Control Hosp Epidemiol 2008, 29: 525-533. 10.1086/588160CrossRefPubMed
39.
go back to reference Cook PP, Das TD, Gooch M, Catrou PG: Effect of a program to reduce hospital ciprofloxacin use on nosocomial Pseudomonas aeruginosa susceptibility to quinolones and other antimicrobial agents. Infect Control Hosp Epidemiol 2008, 29: 716-722. 10.1086/589813CrossRefPubMed Cook PP, Das TD, Gooch M, Catrou PG: Effect of a program to reduce hospital ciprofloxacin use on nosocomial Pseudomonas aeruginosa susceptibility to quinolones and other antimicrobial agents. Infect Control Hosp Epidemiol 2008, 29: 716-722. 10.1086/589813CrossRefPubMed
40.
go back to reference Haley RW, Shachtman RH: The emergence of infection surveillance and control programs in US hospitals: an assessment, 1976. Am J Epidemiol 1980, 111: 574-591.PubMed Haley RW, Shachtman RH: The emergence of infection surveillance and control programs in US hospitals: an assessment, 1976. Am J Epidemiol 1980, 111: 574-591.PubMed
41.
go back to reference Pope SD, Dellit TH, Owens RC, Hooton TM: Results of survey on implementation of Infectious Diseases Society of America and Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Infect Control Hosp Epidemiol 2009, 30: 97-98. 10.1086/592979CrossRefPubMed Pope SD, Dellit TH, Owens RC, Hooton TM: Results of survey on implementation of Infectious Diseases Society of America and Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Infect Control Hosp Epidemiol 2009, 30: 97-98. 10.1086/592979CrossRefPubMed
42.
go back to reference Kollef MH, Sherman G, Ward S, Fraser VJ: Inadequate antimicrobial treatment of infections: A risk factor for hospital mortality among critically ill patients. Chest 1999, 115: 462-474. 10.1378/chest.115.2.462CrossRefPubMed Kollef MH, Sherman G, Ward S, Fraser VJ: Inadequate antimicrobial treatment of infections: A risk factor for hospital mortality among critically ill patients. Chest 1999, 115: 462-474. 10.1378/chest.115.2.462CrossRefPubMed
43.
go back to reference Lawton RM, Fridkin SK, Gaynes RP, McGowan JE Jr: Practices to improve antimicrobial use at 47 US hospitals: The status of the 1997 SHEA/IDSA position paper recommendations. Society for Healthcare Epidemiology of America/Infectious Diseases Society of America. Infect Control Hosp Epidemiol 2000, 21: 256-259. 10.1086/501754CrossRefPubMed Lawton RM, Fridkin SK, Gaynes RP, McGowan JE Jr: Practices to improve antimicrobial use at 47 US hospitals: The status of the 1997 SHEA/IDSA position paper recommendations. Society for Healthcare Epidemiology of America/Infectious Diseases Society of America. Infect Control Hosp Epidemiol 2000, 21: 256-259. 10.1086/501754CrossRefPubMed
44.
go back to reference Barlam TF, DiVall M: Antibiotic-stewardship practices at top academic centers throughout the United States and at hospitals throughout Massachusetts. Infect Control Hosp Epidemiol 2006, 27: 695-703. 10.1086/503346CrossRefPubMed Barlam TF, DiVall M: Antibiotic-stewardship practices at top academic centers throughout the United States and at hospitals throughout Massachusetts. Infect Control Hosp Epidemiol 2006, 27: 695-703. 10.1086/503346CrossRefPubMed
45.
go back to reference Larson EL, Quiros D, Giblin T, Lin S: Relationship of antimicrobial control policies and hospital and infection control characteristics to antimicrobial resistance rates. Am J Crit Care 2007, 16: 110-120.PubMedCentralPubMed Larson EL, Quiros D, Giblin T, Lin S: Relationship of antimicrobial control policies and hospital and infection control characteristics to antimicrobial resistance rates. Am J Crit Care 2007, 16: 110-120.PubMedCentralPubMed
46.
go back to reference Rahal JJ, Urban C, Horn D, Freeman K, Segal-Maurer S, Maurer J, Mariano N, Marks S, Burns JM, Dominick D, Lim M: Class restriction of cephalosporin use to control total cephalosporin resistance in nosocomial Klebsiella. JAMA 1998, 280: 1233-1237. 10.1001/jama.280.14.1233CrossRefPubMed Rahal JJ, Urban C, Horn D, Freeman K, Segal-Maurer S, Maurer J, Mariano N, Marks S, Burns JM, Dominick D, Lim M: Class restriction of cephalosporin use to control total cephalosporin resistance in nosocomial Klebsiella. JAMA 1998, 280: 1233-1237. 10.1001/jama.280.14.1233CrossRefPubMed
47.
go back to reference Paskovaty A, Pflomm JM, Myke N, Seo SK: A multidisciplinary approach to antimicrobial stewardship: Evolution into the 21st century. Int J Antimicrob Agents 2005, 25: 1-10. 10.1016/j.ijantimicag.2004.09.001CrossRefPubMed Paskovaty A, Pflomm JM, Myke N, Seo SK: A multidisciplinary approach to antimicrobial stewardship: Evolution into the 21st century. Int J Antimicrob Agents 2005, 25: 1-10. 10.1016/j.ijantimicag.2004.09.001CrossRefPubMed
48.
go back to reference Gross R, Morgan AS, Kinky DE, Weiner M, Gibson GA, Fishman NO: Impact of a hospital-based antimicrobial management program on clinical and economic outcomes. Clin Infect Dis 2001, 33: 289-295. 10.1086/321880CrossRefPubMed Gross R, Morgan AS, Kinky DE, Weiner M, Gibson GA, Fishman NO: Impact of a hospital-based antimicrobial management program on clinical and economic outcomes. Clin Infect Dis 2001, 33: 289-295. 10.1086/321880CrossRefPubMed
49.
go back to reference Raineri E, Pan A, Mondello P, Acquarolo A, Candiani A, Crema L: Role of the infectious diseases specialist consultant on the appropriateness of antimicrobial therapy prescription in an intensive care unit. Am J Infect Control 2008, 36: 283-290. 10.1016/j.ajic.2007.06.009CrossRefPubMed Raineri E, Pan A, Mondello P, Acquarolo A, Candiani A, Crema L: Role of the infectious diseases specialist consultant on the appropriateness of antimicrobial therapy prescription in an intensive care unit. Am J Infect Control 2008, 36: 283-290. 10.1016/j.ajic.2007.06.009CrossRefPubMed
Metadata
Title
Pro/con debate: Should antimicrobial stewardship programs be adopted universally in the intensive care unit?
Authors
Philip George
Andrew M Morris
Publication date
01-02-2010
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2010
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc8219

Other articles of this Issue 1/2010

Critical Care 1/2010 Go to the issue