LAUSR

Infection remains a daily challenge in the care of critically ill patients. Point prevalence studies suggest that nearly 50% of patients in ICUs globally suffer from acute infection. Pneumonia accounts for more than half of these infections and therefore serves as the major reason for antibiotic use. Concurrently, antibiotic therapy for pneumonia represents a key driver of antimicrobial resistance. Every day the vicious cycle ensues wherein we use broad-spectrum agents to avoid providing inadequate antimicrobial therapy but risk creating further resistance. Although the need for initially appropriate antibiotic therapy is clearly recognized as the main determinant of outcome in severe infection, clinicians struggle to find ways to balance the need to get it right the first time against the cost of promoting further resistance. In essence, the dilemma places the needs of the patient requiring immediate care against the needs of potential future patients.