I would also like to know how far is it possible to follow the principles of ABS using pharmacokinetic & Pharmacodynamic model in ICU ?
usually hospitals have quality committees that address this. In these committees there are pharmacists and physicians that review biograms and use of antibiotics. Generally tho, in the ICU setting, patients are very critical so one must take that into account when thinking of abs
Richard A. Giovane , thank you sir for your answer. As you rightly said, stewardship is a team work and requires assistance from pharmacists, physicians and microbiologists to successfully implement it in ICU. In resource limited settings, we may not have a big team to coordinate the ABS program.The local antibiograms are very useful to guide the intensivist. In India, the bulk of the responsibility falls on the nimble shoulders of the intensivist to ensure that indiscriminate use of antibiotics do not happen in the ICU.
Thank you once again for your response.
Dear Dr. Dutta,
The guidelines are local, national and international.Depending on local or national infection and susceptibility patterns, policies may differ from concurrent international guidelines.
The following are few of the recent guidelines I came across.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193806/
https://www.bjaed.org › fulltext
Antibiotic stewardship in critical care - BJA Educatioks
an environmental bacteriological study of the service is necessary, to take into account that will guide the prescription of empirical antibiotics. this treatment will be adapted later to the antibiogram of the samples of infectious foci.
B.M. Munasinghe , thank you for your inputs and the links that you have sent.
Really helpful!
Thank you once again
Every hospital should have dedicated staff to implement and monitor antibiotic stewardship policies,
The empiric antibiotic prescriptions should be based on hospital wide written antibiotic policy
And escalation should require preauthorization.
In the absence of superspecialist ID personel, ICU doctors and nurses should follow rational Antibiotics policies to curb overuse and Antimicrobial resistance.
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