Infection

, Volume 27, Supplement 2, pp S19–S23

Drug resistance in intensive care units

  • W. C. Albrich
  • M. Angstwurm
  • L. Bader
  • R. Gärtner
Article

DOI: 10.1007/BF02561665

Cite this article as:
Albrich, W.C., Angstwurm, M., Bader, L. et al. Infection (1999) 27(Suppl 2): S19. doi:10.1007/BF02561665

Summary

Intensive care units (ICUs) are generally considered epicenters of antibiotic resistance and the principal sources of outbreaks of multi-resistant bacteria. The most important risk factors are obvious, such as excessive consumption of antibiotics exerting selective pressure on bacteria, the frequent use of invasive devices and relative density of a susceptible patient population with severe underlying diseases. Infections due to antibiotic-resistant bacteria have a major impact on morbidity and health-care costs. Increased mortality is not uniformly shown for all of these organisms: Methicillin-resistantStaphylococcus aureus (MRSA) seems to cause significantly higher mortality, in contrast to vancomycin-resistant enterococci (VRE). Therefore it is essential to diminish these potential risk factors, especially by providing locally adapted guidelines for the prudent use of antibiotic therapy. A quality control of antimicrobial therapy within a hospital, and especially within the ICU, might help to minimize the selection of multidrug-resistant bacteria. The restricted use of antimicrobial agents in prophylaxis and therapy has also been shown to have at least temporal effects on local resistance patterns. New approaches to the problem of drug resistance in ICUs are badly needed.

Copyright information

© Academic Press 1999

Authors and Affiliations

  • W. C. Albrich
    • 1
  • M. Angstwurm
    • 1
  • L. Bader
    • 2
  • R. Gärtner
    • 1
  1. 1.Medizinische KlinikKlinikum Innenstadt der Ludwig-Maximilians-UniversitätMünchen
  2. 2.Max von Pettenkofer Institut der Ludwig-Maximilians-UniversitätMünchen

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