Antimicrobial Therapeutics in Critical Care

The purpose of this manuscript is to summarise current issues in antimicrobial therapeutics, specifically relating to antibacterial drugs, in the critical care setting. Antimicrobial taxonomy, mode of action, pharmacokinetics and pharmacodynamics are important considerations in choosing the most appropriate agent for treatment of infections. Adverse effects of antibiotics can range from mild gastrointestinal disturbance to anaphylactic shock. Prompt escalation and appropriate de-escalation of antimicrobials are central to effective treatment of sepsis associated with important infections in critical care including ventilator-associated pneumonia (VAP) and catheter-related blood stream infection (CRBSI). Improved diagnostic techniques for earlier detection of pathogens may aid such stewardship of antibiotics. The emergence, and continued rise, of antibiotic-resistant bacteria in recent years has highlighted the importance of antimicrobial stewardship.