Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey (2023)

Samenvatting

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.

Originele taal-2English
Artikelnummer131
Aantal pagina's8
TijdschriftAnnals of Intensive Care
Volume11
Nummer van het tijdschrift1
DOI's
StatusPublished - dec.-2021

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    Lanckohr, C., Boeing, C., De Waele, J. J., de Lange, D. W., Schouten, J., Prins, M., Nijsten, M., Povoa, P., Morris, A. C., & Bracht, H. (2021). Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey. Annals of Intensive Care, 11(1), [131]. https://doi.org/10.1186/s13613-021-00917-2

    Lanckohr, Christian ; Boeing, Christian ; De Waele, Jan J. et al. / Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU : results from the international A- TEAMICU survey. In: Annals of Intensive Care. 2021 ; Vol. 11, Nr. 1.

    @article{f91c88c853d74f15ac59dc7c0fa3360a,

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

    abstract = "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.",

    keywords = "Antibiotic, Antimicrobial stewardship, Critical care, Multiresistant bacteria, Therapeutic drug monitoring",

    author = "Christian Lanckohr and Christian Boeing and {De Waele}, {Jan J.} and {de Lange}, {Dylan W.} and Jeroen Schouten and Menno Prins and Maarten Nijsten and Pedro Povoa and Morris, {Andrew Conway} and Hendrik Bracht",

    note = "Funding Information: ACM is supported by an MRC Clinician Scientist Fellowship (MR/V006118/1). Publisher Copyright: {\textcopyright} 2021, The Author(s).",

    year = "2021",

    month = dec,

    doi = "10.1186/s13613-021-00917-2",

    language = "English",

    volume = "11",

    journal = "Annals of Intensive Care",

    issn = "2110-5820",

    publisher = "SpringerOpen",

    number = "1",

    }

    Lanckohr, C, Boeing, C, De Waele, JJ, de Lange, DW, Schouten, J, Prins, M, Nijsten, M, Povoa, P, Morris, AC & Bracht, H 2021, 'Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey', Annals of Intensive Care, vol. 11, nr. 1, 131. https://doi.org/10.1186/s13613-021-00917-2

    Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey. / Lanckohr, Christian; Boeing, Christian; De Waele, Jan J. et al.
    In: Annals of Intensive Care, Vol. 11, Nr. 1, 131, 12.2021.

    OnderzoeksoutputAcademicpeer review

    TY - JOUR

    T1 - Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU

    T2 - results from the international A- TEAMICU survey

    AU - Lanckohr, Christian

    AU - Boeing, Christian

    AU - De Waele, Jan J.

    AU - de Lange, Dylan W.

    AU - Schouten, Jeroen

    AU - Prins, Menno

    AU - Nijsten, Maarten

    AU - Povoa, Pedro

    AU - Morris, Andrew Conway

    AU - Bracht, Hendrik

    N1 - Funding Information:ACM is supported by an MRC Clinician Scientist Fellowship (MR/V006118/1). Publisher Copyright:© 2021, The Author(s).

    PY - 2021/12

    Y1 - 2021/12

    N2 - 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.

    AB - 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.

    KW - Antibiotic

    KW - Antimicrobial stewardship

    KW - Critical care

    KW - Multiresistant bacteria

    KW - Therapeutic drug monitoring

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    U2 - 10.1186/s13613-021-00917-2

    DO - 10.1186/s13613-021-00917-2

    M3 - Article

    AN - SCOPUS:85113478132

    SN - 2110-5820

    VL - 11

    JO - Annals of Intensive Care

    JF - Annals of Intensive Care

    IS - 1

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    Lanckohr C, Boeing C, De Waele JJ, de Lange DW, Schouten J, Prins M et al. Antimicrobial stewardship, therapeutic drug monitoring and infection management in the ICU: results from the international A- TEAMICU survey. Annals of Intensive Care. 2021 dec.;11(1):131. doi: 10.1186/s13613-021-00917-2

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