Use of Antibiotics in Intensive Care Unit: Problems-Antibiotic Policies

Patients admitted to Intensive Care Unit (ICU) are often highly susceptible to infection because of the severity of illness and the invasive devices. Beside the general problem of infection acquisition in the ICU arose another difficulty: the emergence of
microorganisms resistant to antibiotic agents. The high frequency of antimicrobial resistant microorganisms (ARM) is a major public health problem in many countries. Those resistances increase therapeutic failures, costs and morbidity, especially in ICU. ARMs mainly develop in ICU, and this seems due to massive antibiotic use. So, it seems useful to develop rational prescription procedures to reduce antibiotic use and antibiotic-selective pressure.
Most experts in infectious diseases and infection control now recommend a strict limitation of antibiotic use. Several strategies targeted at the use of antimicrobial agents have been suggested to control the emergence of resistance. They include the following: an optimal use of antimicrobial agents, strict control, removal or restriction of the agents, use of antimicrobial agents in combination, and cycling of the available agents.

Keywords: Nosocomial infection, antibiotics, policies