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      Conundrums in the surgical intensive care unit: fevers and antibiotic prophylaxis

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          Abstract

          This editorial is in response to the three latest clinical consensus guidelines authored by the Critical Care Committee of the American Association for the Surgery of Trauma. Herein, we discuss their main findings and recommendations and their impact on the practice of Surgical Critical Care.

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          Surviving Sepsis Campaign : International Guidelines for Management of Sepsis and Septic Shock 2021

          Laura D. Evans, Andrew Rhodes, Waleed Alhazzani … (2021)
          Article 0 comments Cited 520 times – based on 0 reviews     Review now
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            Quantifying drivers of antibiotic resistance in humans: a systematic review

            Anuja Chatterjee, Maryam Modarai, Nichola Naylor … (2018)
            Mitigating the risks of antibiotic resistance requires a horizon scan linking the quality with the quantity of data reported on drivers of antibiotic resistance in humans, arising from the human, animal, and environmental reservoirs. We did a systematic review using a One Health approach to survey the key drivers of antibiotic resistance in humans. Two sets of reviewers selected 565 studies from a total of 2819 titles and abstracts identified in Embase, MEDLINE, and Scopus (2005-18), and the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and WHO (One Health data). Study quality was assessed in accordance with Cochrane recommendations. Previous antibiotic exposure, underlying disease, and invasive procedures were the risk factors with most supporting evidence identified from the 88 risk factors retrieved. The odds ratios of antibiotic resistance were primarily reported to be between 2 and 4 for these risk factors when compared with their respective controls or baseline risk groups. Food-related transmission from the animal reservoir and water-related transmission from the environmental reservoir were frequently quantified. Uniformly quantifying relationships between risk factors will help researchers to better understand the process by which antibiotic resistance arises in human infections.
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              Fever and infections in surgical intensive care: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document

              Eden Nohra, Rachel D Appelbaum, Michael Steven Farrell … (2024)
              The evaluation and workup of fever and the use of antibiotics to treat infections is part of daily practice in the surgical intensive care unit (ICU). Fever can be infectious or non-infectious; it is important to distinguish between the two entities wherever possible. The evidence is growing for shortening the duration of antibiotic treatment of common infections. The purpose of this clinical consensus document, created by the American Association for the Surgery of Trauma Critical Care Committee, is to synthesize the available evidence, and to provide practical recommendations. We discuss the evaluation of fever, the indications to obtain cultures including urine, blood, and respiratory specimens for diagnosis of infections, the use of procalcitonin, and the decision to initiate empiric antibiotics. We then describe the treatment of common infections, specifically ventilator-associated pneumonia, catheter-associated urinary infection, catheter-related bloodstream infection, bacteremia, surgical site infection, intra-abdominal infection, ventriculitis, and necrotizing soft tissue infection.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Trauma Surg Acute Care Open
                Journal ID (iso-abbrev): Trauma Surg Acute Care Open
                Journal ID (hwp): tsaco
                Journal ID (publisher-id): tsaco
                Title: Trauma Surgery & Acute Care Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2397-5776
                Publication date Collection: 2024
                Publication date (Electronic): 3 June 2024
                Volume: 9
                Issue: 1
                Electronic Location Identifier: e001352
                Affiliations
                [1] departmentSurgery , Ringgold_6572University of Pennsylvania , Philadelphia, Pennsylvania, USA
                Author notes
                [Correspondence to ] Dr Niels D Martin; niels.martin@ 123456pennmedicine.upenn.edu
                Author information
                http://orcid.org/0000-0002-0723-0832
                http://orcid.org/0000-0001-9704-0268
                http://orcid.org/0000-0001-8597-6114
                http://orcid.org/0000-0002-2157-0825
                Article
                Publisher ID: tsaco-2023-001352
                DOI: 10.1136/tsaco-2023-001352
                PMC ID: 11149144
                PubMed ID: 38836442
                SO-VID: 10d2ede8-3605-431f-b011-f6999a525260
                Copyright © © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
                License:

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

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                Subject: Commentary
                Subject: 1506
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                Keywords: infections,antibiotic prophylaxis,critical care
                Data availability:
                Keywords: infections, antibiotic prophylaxis, critical care

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