THE USE OF EMPIRICAL ANTIBIOTICS IN THE CRITICAL CARE UNIT

Abstract

Antimicrobial therapy plays a crucial role in managing infections in critically ill patients, yet its indiscriminate use can lead to adverse outcomes. Here, we propose a systematic approach for guiding empirical antimicrobial therapy in intensive care unit (ICU) patients with suspected infections. Diagnostic evaluation, including imaging, laboratory tests, and physical examination, is essential to assess the necessity of antimicrobial treatment. Despite advances, no gold standard biomarker for differentiating infection from inflammation necessitates thorough diagnostic assessment. Prompt microbiological sampling is crucial for accurate diagnosis and tailored treatment. Emergency initiation of antimicrobial therapy is recommended for conditions like sepsis and septic shock, emphasizing the need for timely intervention. Pathogen profiling and consideration of multidrug resistance risk factors are essential for selecting appropriate empirical therapy. Customized evaluation based on patient characteristics and regional trends is paramount for optimal antibiotic selection. Pharmacokinetic and pharmacodynamic parameters should guide dosing to ensure adequate antibacterial levels while minimizing adverse effects. Future research should focus on AI-powered decision-making systems, optimal timelines for starting or postponing therapy, and the environmental impacts of antibiotic use to enhance patient outcomes and reduce antimicrobial resistance.