by Christian Lanckohr, Christian Boeing, Jan J. De Waele,
Dylan W. de Lange, Jeroen Schouten, Menno Prins, Maarten Nijsten, Pedro Povoa,
Andrew Conway Morris and Hendrik Bracht
Annals of
Intensive Care volume 11,
Article number: 131 (2021) Published: 26
August 2021
Background
Severe infections and multidrug-resistant pathogens are
common in critically ill patients. Antimicrobial stewardship (AMS) and
therapeutic drug monitoring (TDM) are contemporary tools to optimize the use of
antimicrobials. The A-TEAMICU survey was initiated to gain contemporary
insights into dissemination and structure of AMS programs and TDM practices in
intensive care units.
Methods
This study involved online survey of members of ESICM and
six national professional intensive care societies.
Results
Data of 812 respondents from mostly European high- and
middle-income countries were available for analysis. 63% had AMS rounds
available in their ICU, where 78% performed rounds weekly or more often. While
82% had local guidelines for treatment of infections, only 70% had cumulative
antimicrobial susceptibility reports and 56% monitored the quantity of
antimicrobials administered. A restriction of antimicrobials was reported by
62%. TDM of antimicrobial agents was used in 61% of ICUs, mostly glycopeptides
(89%), aminoglycosides (77%), carbapenems (32%), penicillins (30%), azole
antifungals (27%), cephalosporins (17%), and linezolid (16%). 76% of
respondents used prolonged/continuous infusion of antimicrobials. The
availability of an AMS had a significant association with the use of TDM.
Conclusions
Many respondents of the survey have AMS in their ICUs. TDM
of antimicrobials and optimized administration of antibiotics are broadly used
among respondents. The availability of antimicrobial susceptibility reports and
a surveillance of antimicrobial use should be actively sought by intensivists
where unavailable. Results of this survey may inform further research and educational activities.
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