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Antimicrobianos en Unidades de Cuidados Intensivos: Uso empírico

2003; SciELO; Volume: 20; Linguagem: Inglês

10.4067/s0716-10182003020100012

0717-6341

Carlos Carmona,

Antibiotic Use and Resistance

Infections are a main cause of mortality in the Intensive Care Units. At the present moment in Chile there is a predominance of Gram positive species (methicillin resistant Staphylococcus aureus, coagulase negative Staphylococci and vancomycin resistant Enterococcus) and multiresistant Gram negative rods (Klebsiella pneumoniae). A late or incorrect prescription of antibiotics enhances significantly the mortality of these infectious episodes. The introduction of automated blood culture and of rapid identification methods allows the indication of broad spectrum antimicrobial agents as initial empirical prescription making adequate and prompt adjustments for each patient. We summarize the advantages and limitations of new drugs potencially active against these multiresistant isolates: cefepime, carbapenems, the new quinolones, pristinamycin, teicoplanin and linezolid. The prescription of antibiotics must be based in the local epidemiology of nosocomial infections and its pattern of resistance.