Antibiotic stewardship in the intensive care unit

Crit Care. 2014 Aug 13;18(5):480. doi: 10.1186/s13054-014-0480-6.


The rapid emergence and dissemination of antimicrobial-resistant microorganisms in ICUs worldwide constitute a problem of crisis dimensions. The root causes of this problem are multifactorial, but the core issues are clear. The emergence of antibiotic resistance is highly correlated with selective pressure resulting from inappropriate use of these drugs. Appropriate antibiotic stewardship in ICUs includes not only rapid identification and optimal treatment of bacterial infections in these critically ill patients, based on pharmacokinetic-pharmacodynamic characteristics, but also improving our ability to avoid administering unnecessary broad-spectrum antibiotics, shortening the duration of their administration, and reducing the numbers of patients receiving undue antibiotic therapy. Either we will be able to implement such a policy or we and our patients will face an uncontrollable surge of very difficult-to-treat pathogens.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Infections / diagnosis
  • Bacterial Infections / drug therapy*
  • Critical Care*
  • Cross Infection / diagnosis
  • Cross Infection / drug therapy*
  • Drug Administration Schedule
  • Drug Resistance, Microbial
  • Humans
  • Inappropriate Prescribing
  • Intensive Care Units


  • Anti-Bacterial Agents