Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM.

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  • Additional Information
    • Affiliation:
      On behalf of the American Thoracic Society, Centers for Disease Control and Prevention, American.
      Association of Critical-Care Nurses, American College of Chest Physicians, and Society of Critical Care Medicine.
    • Abstract:
      Intensive care units (ICUs) are an appropriate focus of antibiotic stewardship program efforts because a large proportion of any hospital's use of parenteral antibiotics, especially broad-spectrum, occurs in the ICU. Given the importance of antibiotic stewardship for critically ill patients and the importance of critical care practitioners as the front line for antibiotic stewardship, a workshop was convened to specifically address barriers to antibiotic stewardship in the ICU and discuss tactics to overcome these. The working definition of antibiotic stewardship is "the right drug at the right time and the right dose for the right bug for the right duration." A major emphasis was that antibiotic stewardship should be a core competency of critical care clinicians. Fear of pathogens that are not covered by empirical antibiotics is a major driver of excessively broad-spectrum therapy in critically ill patients. Better diagnostics and outcome data can address this fear and expand efforts to narrow or shorten therapy. Greater awareness of the substantial adverse effects of antibiotics should be emphasized and is an important counterargument to broad-spectrum therapy in individual low-risk patients. Optimal antibiotic stewardship should not focus solely on reducing antibiotic use or ensuring compliance with guidelines. Instead, it should enhance care both for individual patients (by improving and individualizing their choice of antibiotic) and for the ICU population as a whole. Opportunities for antibiotic stewardship in common ICU infections, including community- and hospital-acquired pneumonia and sepsis, are discussed. Intensivists can partner with antibiotic stewardship programs to address barriers and improve patient care.
    • Journal Subset:
      Biomedical; Peer Reviewed; USA
    • ISSN:
      2325-6621
    • MEDLINE Info:
      PMID: NLM32356696 NLM UID: 101600811
    • Publication Date:
      20200625
    • Publication Date:
      20200625
    • DOI:
      http://dx.doi.org/10.1513/AnnalsATS.202003-188ST
    • Accession Number:
      143028411
  • Citations
    • ABNT:
      WUNDERINK, R. G. et al. Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM. Annals of the American Thoracic Society, [s. l.], v. 17, n. 5, p. 531–540, 2020. DOI 10.1513/AnnalsATS.202003-188ST. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143028411. Acesso em: 12 ago. 2020.
    • AMA:
      Wunderink RG, Srinivasan A, Barie PS, et al. Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM. Annals of the American Thoracic Society. 2020;17(5):531-540. doi:10.1513/AnnalsATS.202003-188ST
    • APA:
      Wunderink, R. G., Srinivasan, A., Barie, P. S., Chastre, J., Dela Cruz, C. S., Douglas, I. S., Ecklund, M., Evans, S. E., Evans, S. R., Gerlach, A. T., Hicks, L. A., Howell, M., Hutchinson, M. L., Hyzy, R. C., Kane-Gill, S. L., Lease, E. D., Metersky, M. L., Munro, N., Niederman, M. S., & Restrepo, M. I. (2020). Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM. Annals of the American Thoracic Society, 17(5), 531–540. https://doi.org/10.1513/AnnalsATS.202003-188ST
    • Chicago/Turabian: Author-Date:
      Wunderink, Richard G., Arjun Srinivasan, Philip S. Barie, Jean Chastre, Charles S. Dela Cruz, Ivor S. Douglas, Margaret Ecklund, et al. 2020. “Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM.” Annals of the American Thoracic Society 17 (5): 531–40. doi:10.1513/AnnalsATS.202003-188ST.
    • Harvard:
      Wunderink, R. G. et al. (2020) ‘Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM’, Annals of the American Thoracic Society, 17(5), pp. 531–540. doi: 10.1513/AnnalsATS.202003-188ST.
    • Harvard: Australian:
      Wunderink, RG, Srinivasan, A, Barie, PS, Chastre, J, Dela Cruz, CS, Douglas, IS, Ecklund, M, Evans, SE, Evans, SR, Gerlach, AT, Hicks, LA, Howell, M, Hutchinson, ML, Hyzy, RC, Kane-Gill, SL, Lease, ED, Metersky, ML, Munro, N, Niederman, MS & Restrepo, MI 2020, ‘Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM’, Annals of the American Thoracic Society, vol. 17, no. 5, pp. 531–540, viewed 12 August 2020, .
    • MLA:
      Wunderink, Richard G., et al. “Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM.” Annals of the American Thoracic Society, vol. 17, no. 5, May 2020, pp. 531–540. EBSCOhost, doi:10.1513/AnnalsATS.202003-188ST.
    • Chicago/Turabian: Humanities:
      Wunderink, Richard G., Arjun Srinivasan, Philip S. Barie, Jean Chastre, Charles S. Dela Cruz, Ivor S. Douglas, Margaret Ecklund, et al. “Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM.” Annals of the American Thoracic Society 17, no. 5 (May 2020): 531–40. doi:10.1513/AnnalsATS.202003-188ST.
    • Vancouver/ICMJE:
      Wunderink RG, Srinivasan A, Barie PS, Chastre J, Dela Cruz CS, Douglas IS, et al. Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM. Annals of the American Thoracic Society [Internet]. 2020 May [cited 2020 Aug 12];17(5):531–40. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143028411