How do you start antibiotics in ICU?
Use empirical therapy first; narrow the spectrum later.
Ensure initial doses are sufficient – under-doing must be avoided. use monotherapy where possible (reduces cost and toxicity).
If the microbiology results suggest decreased susceptibility, consider whether the antibiotics working clinically..
What are empiric antibiotics for critically ill patients?
Even in critically ill patients in the ICU, MDR bacteria are unlikely to be detected in patients without the risk of MDR bacterial infections.
Therefore, for such patients, a strategy of starting empiric narrow-spectrum antimicrobial therapy rather than empiric broad-spectrum therapy should be considered..
What are empirical antibiotics for ICU patients?
Commonly prescribed empirical antibiotics for CAP in ICU such as ampicillin-sulbactam, amoxicillin-clavulanic acid, piperacillin-tazobactam, and carbapenems have excellent anaerobic coverage.
Clindamycin and moxifloxacin are effective against aspiration and lung abscess caused by anaerobic organisms..
What determines the choice of an antibiotic?
Antibiotic selection is a complex task in which many factors, such as clinical condition and tolerance in the patient, the microbiological and clinical efficacy of the antibiotic, ecological risk, and drug cost, must be taken into account [4]..
What factors should be taken into consideration when giving an antibiotic to a patient?
Key Considerations In Appropriate Antibiotic Selection
Spectrum of activity.
This is first on my list. Cost. Route of therapy. Frequency of dosing. Cidality..What is the antibiotic policy in PICU?
All antibiotic must be reviewed at 48 hours.
Antibiotics should be ceased at 48 hours if cultures are negative.
If it is not appropriate to cease antibiotics (because of a high probability of bacterial infection or ongoing signs of sepsis) antibiotic therapy can be scaled down when 48 hour cultures are negative..
- All antibiotic must be reviewed at 48 hours.
Antibiotics should be ceased at 48 hours if cultures are negative.
If it is not appropriate to cease antibiotics (because of a high probability of bacterial infection or ongoing signs of sepsis) antibiotic therapy can be scaled down when 48 hour cultures are negative. - Broad-spectrum antibiotics such as β-lactam/β-lactamase inhibitor combinations (co-amoxiclav and piperacillin–tazobactam), third-generation cephalosporins, quinolones, and carbapenems are useful for initial empirical therapy in critically ill patients.
