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- Title
Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey.
- Authors
Lanckohr, Christian; Boeing, Christian; De Waele, Jan J.; de Lange, Dylan W.; Schouten, Jeroen; Prins, Menno; Nijsten, Maarten; Povoa, Pedro; Morris, Andrew Conway; Bracht, Hendrik
- Abstract
Background: Severe infections and multidrug-resistant pathogens are common in critically ill patients. Antimicrobial stewardship (AMS) and therapeutic drug monitoring (TDM) are contemporary tools to optimize the use of antimicrobials. The A-TEAMICU survey was initiated to gain contemporary insights into dissemination and structure of AMS programs and TDM practices in intensive care units. Methods: This study involved online survey of members of ESICM and six national professional intensive care societies. Results: Data of 812 respondents from mostly European high- and middle-income countries were available for analysis. 63% had AMS rounds available in their ICU, where 78% performed rounds weekly or more often. While 82% had local guidelines for treatment of infections, only 70% had cumulative antimicrobial susceptibility reports and 56% monitored the quantity of antimicrobials administered. A restriction of antimicrobials was reported by 62%. TDM of antimicrobial agents was used in 61% of ICUs, mostly glycopeptides (89%), aminoglycosides (77%), carbapenems (32%), penicillins (30%), azole antifungals (27%), cephalosporins (17%), and linezolid (16%). 76% of respondents used prolonged/continuous infusion of antimicrobials. The availability of an AMS had a significant association with the use of TDM. Conclusions: Many respondents of the survey have AMS in their ICUs. TDM of antimicrobials and optimized administration of antibiotics are broadly used among respondents. The availability of antimicrobial susceptibility reports and a surveillance of antimicrobial use should be actively sought by intensivists where unavailable. Results of this survey may inform further research and educational activities.
- Subjects
DRUG monitoring; ANTIMICROBIAL stewardship; ANTIFUNGAL agents; INTENSIVE care units; ANTI-infective agents; INFECTION
- Publication
Annals of Intensive Care, 2021, Vol 11, Issue 1, p1
- ISSN
2110-5820
- Publication type
Article
- DOI
10.1186/s13613-021-00917-2