Antibiotic prophylaxis in the ICU: to be or not to be administered for patients undergoing procedures?

  • Ignacio Martin-LoechesEmail author
  • Marc Leone
  • Sharon Einav
What's New in Intensive Care
Part of the following topical collections:
  1. Severe infections in the critically ill

Critically ill patients receive antimicrobials for multiple reasons. Antimicrobials may be prescribed as perioperative “prophylaxis” when an intensive care unit (ICU) patient is transferred to the operation room. Such practice is intended to ensure bactericidal serum antibiotic concentrations at the time of surgical incision, as accepted in non-ICU patients. At other times, “prophylactic” antibiotic administration is driven by concerns regarding the tolerance of fragile patients to bacteremia, even when transient [1, 2], and the high likelihood of patient exposure to multiple environmental contaminants [3].

However, administration of unnecessary prophylactic antimicrobial therapy comes at a price; clinicians are often reluctant to stop antimicrobial therapy once it has been initiated, regardless of the appropriateness of treatment [4]. A study conducted in 281 Australian hospitals found that 40% of > 20,000 antibiotics prescribed in hospital wards were inappropriate, mainly due to...



The work was funded by JPIAMR (Grant No. 2018-06335).

Compliance with ethical standards

Conflicts of interest

IML received from MSD, Gilead for lectures and Aguettant for consulting. ML received fees from 3M, Aspen, Edwards, MSD, Octopharma, Orion, Pfizer for lectures and Aguettant, Amomed for consulting. SE have no conflicts of interest.

Supplementary material

134_2019_5870_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)
134_2019_5870_MOESM2_ESM.docx (19 kb)
Supplementary material 2 (DOCX 18 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Multidisciplinary Intensive Care Research Organization (MICRO), St. James’s HospitalDublin 8Ireland
  2. 2.Respiratory Institute, Pulmonary Intensive Care UnitHospital Clinic of Barcelona, IDIBAPSBarcelonaSpain
  3. 3.Department of Anesthesiology and Intensive Care Medicine, Assistance Publique Hôpitaux de Marseille, Nord HospitalAix-Marseille UniversitéMarseilleFrance
  4. 4.General Intensive Care Unit, Shaare Zedek Medical Centre, Faculty of MedicineHebrew UniversityJerusalemIsrael

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