Infectious Disease Chapter 104 ■ the Role of Antibiotics in the Management of Serious Hospital-acquired Infections

Antimicrobial resistance has emerged as an important variable influencing patient mortality and overall resource use in the hospital setting (1). Intensive care units (ICUs) worldwide are faced with increasingly rapid emergence and spread of antibiotic-resistant bacteria. Both antibiotic-resistant Gramnegative and Gram-positive bacteria are reported as important causes of hospital-acquired infections. In many circumstances, particularly with methicillin-resistant Staphylococcus aureus and Enterococcus faecium and Gram-negative bacteria producing extended-spectrum β-lactamases with resistance to multiple other antibiotics, few antimicrobial agents remain for the effective treatment of seriously ill patients (1,2). Within hospitals, ICUs are an important area for the emergence of antimicrobial resistance due to the following (1–6):