Antibiotic Usage and Resistance: Gaining or Losing Ground on Infections in Critically Ill Patients?

In this issue of JAMA, Vincent and colleagues¹ report the results of a remarkable point prevalence survey of infections in intensive care units (ICUs) worldwide and the association of these infections with outcomes of critically ill patients. The study included 13 796 patients present on a single day (May 8, 2007) in more than 1200 ICUs from 75 countries around the world. Known as EPIC II (Extended Prevalence of Infection in the ICU), the study is a 15-year follow-up to another point prevalence investigation, EPIC (European Prevalence of Infection in the ICU),² which was conducted in 1995 and included 10 038 patients, primarily from ICUs in western Europe; many of the same European institutions participated in both studies. The scope and magnitude of EPIC II, the largest of any ICU infection prevalence study, reveals several noteworthy insights into the current practice patterns of antibiotic use and infection risks in ICU patients.