To which extent can we decrease antibiotic duration in critically ill patients?

José Garnacho-Montero, Angel Arenzana-Seisdedos, Jan De Waele, Marin H. Kollef

Research output: Contribution to journalReview article

1 Scopus citations

Abstract

Introduction: Inadequate empirical antibiotic therapy is associated with higher mortality in critically ill patients with severe infections. Nevertheless, prolonged duration of antibiotic treatment is also potentially harmful. Development of new infections with more resistant pathogens is one of the arguments against the administration of prolonged courses of antibiotics. Areas covered: We aim to describe the optimal duration of antimicrobial therapy in the most common infections affecting critically ill patients. A literature search was performed to identify all clinical trials, observational studies, meta-analysis, and reviews about this topic from PubMed. Expert commentary: Diverse observational studies have reported a poor outcome in critically ill patients without a documented infection who receive prolonged antibiotic therapy. We summarize the available information about the optimal duration of antimicrobial therapy in critically ill patients with severe infections including community-acquired pneumonia, intra-abdominal infections, bacteremia, meningitis and urinary-tract infections as well as the clinical consequences of short antimicrobial courses in certain severe infections. The utility of procalcitonin to reduce the duration of antibiotics is also discussed. Finally, we give clear recommendations about the length of treatment for the most common infections in critically ill patients.

Original languageEnglish
Pages (from-to)1215-1223
Number of pages9
JournalExpert Review of Clinical Pharmacology
Volume10
Issue number11
DOIs
StatePublished - Nov 2 2017

Keywords

  • Candidemia
  • Critically ill patient
  • antimicrobial therapy
  • pneumonia
  • procalcitonin
  • ventilator-associated pneumonia

Fingerprint Dive into the research topics of 'To which extent can we decrease antibiotic duration in critically ill patients?'. Together they form a unique fingerprint.

  • Cite this