ICU learning pathway | Principles of antibiotic use

Principles of Antibiotic Use
Session Overview
Description
This session will revise the definition, classification and mechanism of action of commonly used antibiotics. The principles of antibiotic use in a variety of clinical situations will be covered and the problem of antimicrobial resistance to antibiotics will also be discussed.

By the end of this session you will be able to:

• Define antibiotics
• Describe how antibiotics may be classified according to their chemical group and mechanism of action
• Explain how to make a rational choice of antibiotic based on its spectrum of antimicrobial activity
• Describe the significance of resistance to antibiotics
• Appreciate the problem of nosocomial infection, illustrated by Clostridium difficile infection
• Describe the importance of seeking expert advice from a microbiologist
• Describe non-antibiotic aspects of infection prevention and control

Infection is an increasingly common problem in hospitalized patients in the UK. Hospital-acquired (nosocomial) infections affect one in ten patients admitted to UK hospitals, resulting in more than 5000 deaths a year and costing the NHS £1bn.

There are a variety of reasons for the increasing problem of infection, including the admission and treatment of ever older and sicker patients with multiple comorbidities and significant immunocomprise.

Severe sepsis has a high mortality and is the commonest reason for admission to an adult general intensive care unit in the UK. Published data from the Intensive Care National Audit and Research Centre (ICNARC) database suggest that nearly 30 % of all admissions to adult general ICUs have severe sepsis with a hospital mortality of over 40 %.

This session will cover the definition, classification and mechanism of action of commonly used antibiotics. It will present a rationale for appropriate use of antibiotics. Mechanisms of antibiotic resistance will also be covered.