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Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey

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cam.issuedOnline2021-08-26
dc.contributor.authorLanckohr, Christian
dc.contributor.authorBoeing, Christian
dc.contributor.authorDe Waele, Jan J
dc.contributor.authorde Lange, Dylan W
dc.contributor.authorSchouten, Jeroen
dc.contributor.authorPrins, Menno
dc.contributor.authorNijsten, Maarten
dc.contributor.authorPovoa, Pedro
dc.contributor.authorMorris, Andrew Conway
dc.contributor.authorBracht, Hendrik
dc.date.accessioned2021-10-29T23:30:49Z
dc.date.available2021-10-29T23:30:49Z
dc.date.issued2021-08-26
dc.description.abstractBACKGROUND: 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.
dc.description.sponsorshipMRC Clinician Scientist Fellowship (MR/V006118/1)
dc.identifier.doi10.17863/CAM.77506
dc.identifier.eissn2110-5820
dc.identifier.issn2110-5820
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330062
dc.languageeng
dc.language.isoeng
dc.publisherSpringer
dc.publisher.urlhttp://dx.doi.org/10.1186/s13613-021-00917-2
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectAntibiotic
dc.subjectAntimicrobial stewardship
dc.subjectCritical care
dc.subjectMultiresistant bacteria
dc.subjectTherapeutic drug monitoring
dc.titleAntimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey
dc.typeArticle
dcterms.dateAccepted2021-08-05
prism.endingPage131
prism.publicationNameAnnals of Intensive Care
prism.startingPage131
prism.volume11
pubs.funder-project-idMRC (MR/V006118/1)
pubs.funder-project-idWellcome Trust (205214/Z/16/Z)
rioxxterms.licenseref.startdate2021-08-05
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1186/s13613-021-00917-2

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