UMEM Educational Pearls

Category: Critical Care

Title: When to stop antibiotics in the ICU?

Keywords: antibiotics, drug resistance, (PubMed Search)

Posted: 1/5/2016 by Feras Khan, MD
Click here to contact Feras Khan, MD

Happy New Year!!!

My new year's resolution is to use less antibiotics (and eat more Cap'n Crunch Berries)

Will I be successful?

A multi-center, ICU, observational study looking at over 900 patients from 67 ICUs showed that half of all empiric antibiotics ordered in patients are continued for at least 72 hours in the abscence of adjudicated infection.

  • We have been well trained to start antibiotics but stopping or limiting use can be difficult
  • The greater the severity of illness, the longer the antibiotics were continued in this study

Things to consider:

The same way we try and limit central line use, we should try and decrease antibiotic usage on a daily basis

Tips to decrease use: daily clinical pharmacist input, ID specialist involvement, automated stop dates, 72 hour vancomycin cessation protocols, incentives for de-escalation, educational resources


Critical Care Medicine:
doi: 10.1097/CCM.0000000000001294
Feature Article

A Multicenter Evaluation of Prolonged Empiric Antibiotic Therapy in Adult ICUs in the United States

Thomas, Zachariah PharmD