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October 8, 2014

Rational Use of Antibiotics in the ICUBalancing Stewardship and Clinical Outcomes

Author Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, Missouri
  • 2St Louis College of Pharmacy, St Louis, Missouri
JAMA. 2014;312(14):1403-1404. doi:10.1001/jama.2014.8427

Clinicians working in the intensive care unit (ICU) setting encounter the dilemma of prescribing antibiotics to treat critically ill patients with serious infections while minimizing the emergence and spread of antimicrobial resistance. Delaying the administration of appropriate antibiotic therapy (ie, an antibiotic regimen active against the causative pathogen based on in vitro testing) in the ICU has been associated with an increase in hospital mortality.1 One of the most important risk factors for delayed appropriate antibiotic therapy in seriously ill infected patients is prior exposure to antibiotics, typically administered within the previous 90 days.1

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