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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

Impact of a Multimodal Antimicrobial Stewardship Program on Pseudomonas aeruginosa Susceptibility and Antimicrobial

Douglas Slain1, Arif R Sarwari, Karen O Petros

  • 1Division of Infectious Diseases, West Virginia University (WVU), Morgantown, WV 26506-9163, USA.

Critical Care Research and Practice
|June 21, 2011
PubMed

Insights

A multimodal antibiotic stewardship program in the ICU reduced antibiotic use but did not statistically correlate with Pseudomonas aeruginosa resistance rates, indicating the complexity of antibiotic resistance.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Antimicrobial Stewardship

Background:

  • Antibiotic resistance is a growing threat in intensive care units (ICUs).
  • Effective antibiotic stewardship programs are crucial for managing resistance.
  • Pseudomonas aeruginosa is a common ICU pathogen associated with significant resistance.

Purpose of the Study:

  • To evaluate the impact of a multimodal antibiotic stewardship program on Pseudomonas aeruginosa susceptibility.
  • To assess changes in antibiotic utilization within the ICU setting.

Main Methods:

  • Implementation of a comprehensive stewardship program based on established guidelines.
  • Prospective audits, feedback, formulary restrictions, and educational interventions.
  • Measurement of ICU antibiotic use in defined daily doses (DDD) per 1,000 patient-days.

Main Results:

  • A significant decline in the use of intravenous ciprofloxacin and ceftazidime was observed post-implementation.
  • Increased use and resistance rates of these agents were noted in a subsequent period.
  • No statistically significant relationship was found between stewardship efforts and P. aeruginosa resistance rates.

Conclusions:

  • Multimodal antibiotic stewardship programs can influence antibiotic prescribing patterns in ICUs.
  • Preventing antibiotic resistance is complex and stewardship programs have limitations.
  • Further research is needed to fully understand and combat ICU-related antibiotic resistance.

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