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Updated: Oct 12, 2025
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
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Antibiotic Therapy in the Intensive Care Unit
1Division of Acute Care and Regional General Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, G5/332A, 600 Highland Avenue, Madison, WI 53792, USA.
The Surgical Clinics of North America
|November 20, 2021
Summary
Antibiotic resistance is a growing concern. Critical care clinicians must balance effective treatment with preserving antibiotics, especially in intensive care unit (ICU) patients with inflammatory responses.
Area of Science:
- Critical care medicine
- Infectious diseases
- Pharmacology
Background:
- Antibiotic resistance poses a significant public health threat.
- Critical care clinicians face challenges in treating infections while conserving antibiotic effectiveness.
- Differentiating inflammation from infection in intensive care unit (ICU) patients, particularly postoperative and trauma cases, is complex due to systemic inflammatory responses.
Purpose of the Study:
- To address the clinical dilemma of selecting appropriate empirical antibiotic therapy in ICUs.
- To emphasize individualized treatment decisions based on patient status and local resistance patterns.
- To highlight the importance of antibiotic stewardship in critical care settings.
Main Methods:
- Review of clinical decision-making processes for empirical antibiotic therapy in ICUs.
- Emphasis on individualized patient assessment, considering local ecology and resistance data.
- Discussion of the de-escalation strategy post-microbiology data availability.
Main Results:
- Empirical therapy decisions must be tailored to individual patients and local resistance profiles.
- De-escalation of antibiotic therapy is crucial once microbiological data are obtained.
- Antibiotic stewardship programs are vital for effective management in the ICU.
Conclusions:
- Individualized empirical antibiotic therapy and timely de-escalation are key in ICU settings.
- Robust antibiotic stewardship programs are essential to combat antibiotic resistance.
- Effective management requires balancing immediate treatment needs with long-term antibiotic preservation.
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