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Updated: Oct 19, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Influences of alternate therapy protocol and continuous infectious disease consultation on antibiotic susceptibility

H Akalin1, F Kahveci, C Ozakin

  • 1Uludağ University, School of Medicine, Department of Microbiology and Infectious Diseases, 16 059 Görükle, Bursa, Turkey. halis@uludag.edu.tr

Intensive Care Medicine
|September 29, 1999
PubMed

Insights

Alternate antibiotic therapy in the intensive care unit (ICU) improved bacterial sensitivity. This strategy enhanced the effectiveness of key antibiotics against common ICU pathogens.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Antimicrobial Stewardship

Background:

  • Antibiotic resistance is a growing threat in intensive care units (ICUs).
  • Effective antibiotic strategies are crucial for managing infections in critically ill patients.
  • The study investigated the impact of a specific antibiotic rotation protocol.

Purpose of the Study:

  • To evaluate the effect of alternating imipenem and cefoperazone/sulbactam (CFP/Sul) on antibiotic resistance patterns.
  • To assess the impact of a structured antibiotic stewardship protocol on microbial sensitivity.
  • To determine changes in the susceptibility of common ICU pathogens to various antibiotics.

Main Methods:

  • A comparative study design was employed, comparing two periods with different antibiotic management strategies.
  • The first period involved on-demand antibiotic consultation, while the second implemented a daily follow-up and alternative therapy protocol.
  • Microorganism identification and antibiotic sensitivity testing were performed for common ICU isolates.

Main Results:

  • The implementation of the alternative therapy protocol led to improved sensitivity rates for imipenem, ciprofloxacin, and aminoglycosides.
  • Acinetobacter baumannii and Staphylococcus aureus were the most prevalent microorganisms identified.
  • Pseudomonas aeruginosa and Klebsiella pneumoniae were also frequently observed pathogens.

Conclusions:

  • The alternate use of imipenem and cefoperazone/sulbactam, as part of a structured protocol, can enhance antibiotic effectiveness.
  • Antimicrobial stewardship programs involving active patient follow-up are beneficial in combating antibiotic resistance in ICUs.
  • Improved sensitivity to commonly used antibiotics was observed following the protocol implementation.

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