Which trial do we need? Bundle including antibiotic monitoring, rapid antibiotic susceptibility testing and molecular biology in septic shock

Dudoignon, Emmanuel; Baekgaard, Josefine S.; Léone, Marc; Dépret, François

doi:10.1016/j.cmi.2023.04.003

Cited by 2 publications

(1 citation statement)

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“…The appropriate timing for antibiotic administration in patients without shock with possible infection/sepsis is still object of discussion, particularly in critically ill patients with pre-existing organ dysfunction. Recently, a trial protocol including most of the main components of ASPs in ICU was proposed underlying the need for testing ASPs components as a unique intervention [74]. Indeed, patients with septic shock in early phase would be randomized in a cluster randomized, multicenter, trial to a personalized management strategy including rapid microbiological identification with adaptation of antibiotic dosages according to the daily TDM based on real MIC of the identified isolates versus standard care.…”

Section: Insights For Future Researchmentioning

confidence: 99%

Rationale and clinical application of antimicrobial stewardship principles in the intensive care unit: a multidisciplinary statement

Cortegiani

Antonelli

Falcone

et al. 2023

J Anesth Analg Crit Care

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Background Antimicrobial resistance represents a major critical issue for the management of the critically ill patients hospitalized in the intensive care unit (ICU), since infections by multidrug-resistant bacteria are characterized by high morbidity and mortality, high rates of treatment failure, and increased healthcare costs worldwide. It is also well known that antimicrobial resistance can emerge as a result of inadequate antimicrobial therapy, in terms of drug selection and/or treatment duration. The application of antimicrobial stewardship principles in ICUs improves the quality of antimicrobial therapy management. However, it needs specific considerations related to the critical setting. Methods The aim of this consensus document gathering a multidisciplinary panel of experts was to discuss principles of antimicrobial stewardship in ICU and to produce statements that facilitate their clinical application and optimize their effectiveness. The methodology used was a modified nominal group discussion. Conclusion The final set of statements underlined the importance of the specific interpretation of antimicrobial stewardship’s principles in critically ill patient management, quasi-targeted therapy, the use of rapid diagnostic methods, the personalization of antimicrobial therapies’ duration, obtaining microbiological surveillance data, the use of PK/PD targets, and the use of specific indicators in antimicrobial stewardship programs.

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Section: Insights For Future Researchmentioning

confidence: 99%