[Tarragona strategy--appropriate antibiotic therapy in the ICU]

Appropriate antibiotic initial therapy remarkably decreases the mortality of patients with infections in the ICU. The establishment of an appropriate initial therapy follows empirical aspects. This practice was first done for the treatment of nosocomial pneumonia. Since that time the practice became known as Tarragona strategy.

The basic elements of the strategy are based on the initial antibiotic treatment of patients with infections in the ICU in general and include the following: view the patient and his/her medical history, consider the microbiologic environment, in which the patient became ill, test for possible causative microorganisms and initiate high-dose antibiotics immediately, evaluate pharmacokinetic/pharmacodynamic aspects influenced by the pathophysiologic processes in the critically ill patient, the specifics of the microorganisms, the peculiarity of the antibiotics in the patient and due to therapeutic procedures, and tailor the initial broad spectrum therapy as necessary according to the microbiological results.

This procedure is safe, reduces mortality, limits the development of resistance, and is economic.