Efforts of pharmacy to reduce antibiotic resistance

Pharmacists have an integral role in the care of ICU patients, including those with infections. Antibiotics continue to be among the most widely prescribed drugs in the ICU environment. This article focuses on the impact pharmacists have on the care and economics for the critically ill infected patient and on mechanisms used in hospitals to control antibiotic misuse. Numerous studies point to inappropriate antibiotic use and resultant selection pressure on antimicrobial resistance. The critical care pharmacist can impact this prescribing by assuring optimal pharmacotherapy specific for the organism and associated disease. Furthermore, policies have been implemented to modify antibiotic use, including formulary manipulations, antibiotic stop order forms, care plans, antibiotic cycling, oral switching, and computer-assisted antimicrobial therapy. Future research is needed to determine the optimal method for preventing resistance. However, a multidisciplinary approach to rational antimicrobial use is suggested.