Publicação
Antimicrobial Stewardship in the Intensive Care Unit
| Resumo: | The high prevalence of infectious diseases in the intensive care unit (ICU) and consequently elevated pressure for immediate and effective treatment have led to increased antimicrobial therapy consumption and misuse. Moreover, the emerging global threat of antimicrobial resistance and lack of novel antimicrobials justify the implementation of judicious antimicrobial stewardship programs (ASP) in the ICU. However, even though the importance of ASP is generally accepted, its implementation in the ICU is far from optimal and current evidence regarding strategies such as de-escalation remains controversial. The limitations of clinical guidance for antimicrobial therapy initiation and discontinuation have led to multiple studies for the evaluation of more objective tools, such as biomarkers as adjuncts for ASP. C-reactive protein and procalcitonin can be adequate for clinical use in acute infectious diseases, the latter being the most studied for ASP purposes. Although promising, current evidence highlights challenges in biomarker application and interpretation. Furthermore, the physiological alterations in the critically ill render pharmacokinetics and pharmacodynamics crucial parameters for adequate antimicrobial therapy use. Individual pharmacokinetic and pharmacodynamic targets can reduce antimicrobial therapy misuse and risk of antimicrobial resistance. |
|---|---|
| Autores principais: | Moniz, Patrícia |
| Outros Autores: | Coelho, Luís; Póvoa, Pedro; Povoa, Pedro |
| Assunto: | Antimicrobial stewardship Biomarkers De-escalation Pharmacodynamics Pharmacokinetics Pharmacology (medical) SDG 3 - Good Health and Well-being |
| Ano: | 2021 |
| País: | Portugal |
| Tipo de documento: | recensão |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade Nova de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório Institucional da UNL |
| _version_ | 1865920606492426240 |
|---|---|
| author | Moniz, Patrícia |
| author2 | Coelho, Luís Póvoa, Pedro Povoa, Pedro |
| author2_role | author author author |
| author_facet | Moniz, Patrícia Moniz, Patrícia Coelho, Luís Póvoa, Pedro Povoa, Pedro Coelho, Luís Póvoa, Pedro Povoa, Pedro |
| author_role | author |
| contributor_name_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Springer Science Business Media RUN |
| country_str | PT |
| creators_json_str | [{\"Person.name\":\"Moniz, Patrícia\"},{\"Person.name\":\"Coelho, Luís\"},{\"Person.name\":\"Póvoa, Pedro\"},{\"Person.name\":\"Povoa, Pedro\",\"Person.identifier.orcid\":\"0000-0002-7069-7304\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Springer Science Business Media RUN |
| datacite.creators.creator.creatorName.fl_str_mv | Moniz, Patrícia Coelho, Luís Póvoa, Pedro Povoa, Pedro |
| datacite.date.Accepted.fl_str_mv | 2021-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2022-10-20T22:09:44Z |
| datacite.date.embargoed.fl_str_mv | 2022-10-20T22:09:44Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Antimicrobial stewardship Biomarkers De-escalation Pharmacodynamics Pharmacokinetics Pharmacology (medical) SDG 3 - Good Health and Well-being |
| datacite.titles.title.fl_str_mv | Antimicrobial Stewardship in the Intensive Care Unit The Role of Biomarkers, Pharmacokinetics, and Pharmacodynamics |
| dc.contributor.none.fl_str_mv | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Springer Science Business Media RUN |
| dc.creator.none.fl_str_mv | Moniz, Patrícia Coelho, Luís Póvoa, Pedro Povoa, Pedro |
| dc.date.Accepted.fl_str_mv | 2021-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2022-10-20T22:09:44Z |
| dc.date.embargoed.fl_str_mv | 2022-10-20T22:09:44Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10362/144861 |
| dc.language.none.fl_str_mv | eng |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Antimicrobial stewardship Biomarkers De-escalation Pharmacodynamics Pharmacokinetics Pharmacology (medical) SDG 3 - Good Health and Well-being |
| dc.title.fl_str_mv | Antimicrobial Stewardship in the Intensive Care Unit The Role of Biomarkers, Pharmacokinetics, and Pharmacodynamics |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_efa0 |
| description | The high prevalence of infectious diseases in the intensive care unit (ICU) and consequently elevated pressure for immediate and effective treatment have led to increased antimicrobial therapy consumption and misuse. Moreover, the emerging global threat of antimicrobial resistance and lack of novel antimicrobials justify the implementation of judicious antimicrobial stewardship programs (ASP) in the ICU. However, even though the importance of ASP is generally accepted, its implementation in the ICU is far from optimal and current evidence regarding strategies such as de-escalation remains controversial. The limitations of clinical guidance for antimicrobial therapy initiation and discontinuation have led to multiple studies for the evaluation of more objective tools, such as biomarkers as adjuncts for ASP. C-reactive protein and procalcitonin can be adequate for clinical use in acute infectious diseases, the latter being the most studied for ASP purposes. Although promising, current evidence highlights challenges in biomarker application and interpretation. Furthermore, the physiological alterations in the critically ill render pharmacokinetics and pharmacodynamics crucial parameters for adequate antimicrobial therapy use. Individual pharmacokinetic and pharmacodynamic targets can reduce antimicrobial therapy misuse and risk of antimicrobial resistance. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | review |
| fulltext.url.fl_str_mv | https://run.unl.pt/bitstreams/fb8f2569-0f84-4eb4-bd36-2c1333b91beb/download |
| id | run_00a9903456ba0a3b2e5d795d5b1f3ea4 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10362/144861 |
| instacron_str | unl |
| institution | Universidade Nova de Lisboa |
| instname_str | Universidade Nova de Lisboa |
| language | eng |
| network_acronym_str | run |
| network_name_str | Repositório Institucional da UNL |
| oai_identifier_str | oai:run.unl.pt:10362/144861 |
| organization_str_mv | urn:organizationAcronym:unl |
| person_str_mv | Moniz, Patrícia Coelho, Luís Póvoa, Pedro Povoa, Pedro Povoa, Pedro https://www.ciencia-id.pt/0C16-5CF9-9238 0C16-5CF9-9238 http://orcid.org/0000-0002-7069-7304 0000-0002-7069-7304 |
| publishDate | 2021 |
| reponame_str | Repositório Institucional da UNL |
| repository_id_str | urn:repositoryAcronym:run |
| service_str_mv | urn:repositoryAcronym:run |
| spelling | engenThe high prevalence of infectious diseases in the intensive care unit (ICU) and consequently elevated pressure for immediate and effective treatment have led to increased antimicrobial therapy consumption and misuse. Moreover, the emerging global threat of antimicrobial resistance and lack of novel antimicrobials justify the implementation of judicious antimicrobial stewardship programs (ASP) in the ICU. However, even though the importance of ASP is generally accepted, its implementation in the ICU is far from optimal and current evidence regarding strategies such as de-escalation remains controversial. The limitations of clinical guidance for antimicrobial therapy initiation and discontinuation have led to multiple studies for the evaluation of more objective tools, such as biomarkers as adjuncts for ASP. C-reactive protein and procalcitonin can be adequate for clinical use in acute infectious diseases, the latter being the most studied for ASP purposes. Although promising, current evidence highlights challenges in biomarker application and interpretation. Furthermore, the physiological alterations in the critically ill render pharmacokinetics and pharmacodynamics crucial parameters for adequate antimicrobial therapy use. Individual pharmacokinetic and pharmacodynamic targets can reduce antimicrobial therapy misuse and risk of antimicrobial resistance.application/pdfenAntimicrobial Stewardship in the Intensive Care UnitSubtitleenThe Role of Biomarkers, Pharmacokinetics, and PharmacodynamicsMoniz, PatríciaCoelho, LuísPóvoa, PedroPersonalPovoa, PedroDSpacehttp://dspace.org/items/04ec38ba-be1e-46e5-8007-0e65a557d0f4DSpacehttp://dspace.org/items/04ec38ba-be1e-46e5-8007-0e65a557d0f4PovoaPedroCiência IDhttps://www.ciencia-id.pt0C16-5CF9-9238ORCIDhttp://orcid.org0000-0002-7069-7304Scopus Author IDhttps://www.scopus.com6602772147Scopus Author IDhttps://www.scopus.com57515497300NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Springer Science Business MediaHostingInstitutionOrganizationalRUNe-mailmailto:run@unl.ptrun@unl.ptISSNIsPartOf0741-238XURNIsPartOfPURE: 26663432URNIsPartOfPURE UUID: c90c0708-c475-407b-8b3a-b47e1e63e788URNIsPartOfScopus: 85096369961URNIsPartOfWOS: 000591091000001URNIsPartOfPubMed: 33216323DOIIsPartOf10.1007/s12325-020-01558-w2022-10-20T22:09:44Z20212021-01-01T00:00:00ZHandlehttp://hdl.handle.net/10362/144861http://purl.org/coar/access_right/c_abf2open accessAntimicrobial stewardshipBiomarkersDe-escalationPharmacodynamicsPharmacokineticsPharmacology (medical)SDG 3 - Good Health and Well-being373599 bytesother research producthttp://purl.org/coar/resource_type/c_efa0reviewhttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://run.unl.pt/bitstreams/fb8f2569-0f84-4eb4-bd36-2c1333b91beb/download |
| spellingShingle | Antimicrobial Stewardship in the Intensive Care Unit Antimicrobial Stewardship in the Intensive Care Unit Moniz, Patrícia Antimicrobial stewardship Biomarkers De-escalation Pharmacodynamics Pharmacokinetics Pharmacology (medical) SDG 3 - Good Health and Well-being Moniz, Patrícia Antimicrobial stewardship Biomarkers De-escalation Pharmacodynamics Pharmacokinetics Pharmacology (medical) SDG 3 - Good Health and Well-being |
| status | NEW |
| subject.fl_str_mv | Antimicrobial stewardship Biomarkers De-escalation Pharmacodynamics Pharmacokinetics Pharmacology (medical) SDG 3 - Good Health and Well-being |
| title | Antimicrobial Stewardship in the Intensive Care Unit |
| title_full | Antimicrobial Stewardship in the Intensive Care Unit |
| title_fullStr | Antimicrobial Stewardship in the Intensive Care Unit Antimicrobial Stewardship in the Intensive Care Unit |
| title_full_unstemmed | Antimicrobial Stewardship in the Intensive Care Unit Antimicrobial Stewardship in the Intensive Care Unit |
| title_short | Antimicrobial Stewardship in the Intensive Care Unit |
| title_sort | Antimicrobial Stewardship in the Intensive Care Unit |
| topic | Antimicrobial stewardship Biomarkers De-escalation Pharmacodynamics Pharmacokinetics Pharmacology (medical) SDG 3 - Good Health and Well-being |
| topic_facet | Antimicrobial stewardship Biomarkers De-escalation Pharmacodynamics Pharmacokinetics Pharmacology (medical) SDG 3 - Good Health and Well-being |
| url | http://hdl.handle.net/10362/144861 |
| visible | 1 |