Antibiotic Stewardship and Infection Control Strategies in Critical Care

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 30 November 2025 | Viewed by 584

Special Issue Editor


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Guest Editor
Grupo de Investigação e Desenvolvimento em Infeção e Sépsis, Serviço de Medicina Intensiva, Hospital Santa Maria, Clínica Universitária de Medicina Intensiva, Faculdade de Medicina, Universidade de Lisboa, 1649-004 Lisbon, Portugal
Interests: antibiotics; critical care; sepsis; immune dysfunction

Special Issue Information

Dear Colleagues,

Antibiotic stewardship in Intensive Care Units (ICUs) is crucial for enhancing patient outcomes and combating antibiotic resistance. Patients in the ICU often have or acquire severe infections, making them vulnerable to the overuse and misuse of antibiotics. Effective stewardship programs promote the appropriate use of these medications, ensuring that antibiotics are prescribed only when necessary and that the right drug, dose, and duration are selected.

Implementing stewardship practices in ICUs can lead to a significant reduction in antibiotic resistance, a major global health concern. This reduction can directly improve patient outcomes and reduce healthcare costs. Thus, an effective stewardship program involves regular review of antibiotic prescriptions, education for healthcare professionals, and the use of protocols to streamline antibiotic therapy.

Despite the certain relevance of stewardship programs, there are still many knowledge gaps in this field: How should stewardship programs be implemented, and what would we aim for regarding infection control? What antibiotic strategies should be implemented in different ICUs to decrease antibiotic resistance? Are there differences between polyvalent ICUs and surgical, cardiac, or neurocritical ICUs? Is it possible to decrease antibiotic time in severe infections apart from pneumonia or secondary peritonitis, and how far can we go? These are just some of the questions requiring scientific answers.

In this Special Issue, we will accept any outstanding article in this field. Together we will make a difference, improve stewardship practices in ICUs, and improve infection control.

Dr. Susana M. Fernandes
Guest Editor

Manuscript Submission Information

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Keywords

  • infection prevention
  • critical care
  • sepsis
  • stewardship practices

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Published Papers (1 paper)

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Research

12 pages, 534 KiB  
Article
Optimizing Antibiotic Treatment Duration for ESBL-Producing Enterobacteriaceae Bacteremia in ICU: A Multicentric Retrospective Cohort Study
by Camille Le Berre, Maxime Degrendel, Marion Houard, Lucie Benetazzo, Anne Vachée, Hugues Georges, Frederic Wallet, Pierre Patoz, Perrine Bortolotti, Saad Nseir, Pierre-Yves Delannoy and Agnès Meybeck
Antibiotics 2025, 14(4), 358; https://doi.org/10.3390/antibiotics14040358 - 1 Apr 2025
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Abstract
Background: The optimal duration of antibiotic treatment for extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) bloodstream infections (BSI) in intensive care unit (ICU) is not established. We aim to evaluate the frequency and clinical outcomesof a short appropriate antibiotic treatment (≤7 days) (SAT) for ESBL-E BSI [...] Read more.
Background: The optimal duration of antibiotic treatment for extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) bloodstream infections (BSI) in intensive care unit (ICU) is not established. We aim to evaluate the frequency and clinical outcomesof a short appropriate antibiotic treatment (≤7 days) (SAT) for ESBL-E BSI acquired in the ICU. We specifically assessed the rate of ESBL-E BSI relapse, and in-ICU mortality. Method: All patients who acquired ESBL-E BSI in three ICU in Northern France between January 2011 and June 2022 were included in a multicenter retrospective cohort study. The factors associated with prescribing short (SAT, ≤7 days) versus long (LAT, >7 days) antibiotic treatment were analyzed. To evaluate the impact of SAT on mortality in the ICU, an estimation was applied using a Cox model with a time-dependent co-variable adjusted by inverse weighting of the propensity score. Results: In total, 379 patients were included. The proportion of patients receiving a SAT was 40% in the entire cohort and 25% in survivors beyond 7 days. In bivariate analysis, the factors associated with prescribing a SAT in survivors were shorter pre-bacteremia ICU stay (p = 0.005), lower proportion of chronic renal failure history (p = 0.034), cancer (p = 0.042), or transplantation (p = 0.025), less frequent exposure to carbapenem within 3 months (p = 0.015). There was a higher proportion of septic shock (p = 0.017) or bacteremia secondary to pneumonia (p = 0.003) in the group of survivors receiving a LAT. After adjustment, no difference in survival was found between the two groups (HR: 1.65, 95%CI: 0.91–3.00, p = 0.10). Conclusion: In our cohort, one quarter of patients with ESBL-E bacteremia acquired in the ICU surviving beyond 7 days were treated with a SAT. SAT did not appear to affect survival. Patients who could benefit from a SAT need to be better identified. Full article
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