{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T22:43:28Z","timestamp":1789512208482,"version":"build-2803163510"},"reference-count":13,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2018,5,25]],"date-time":"2018-05-25T00:00:00Z","timestamp":1527206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Antimicrobial resistance is escalating and triggers clinical decision-making challenges when treating infections in patients admitted to intensive care units (ICU). Antimicrobial stewardship (AMS) may help combat this problem, but it can be difficult to implement in critical care settings. The implementation of multidisciplinary AMS in ICUs could be more challenging than what is currently suggested in the literature. Our main goal was to analyze the reduction in duration of treatment (DOT) for the most commonly used antibacterial and antifungal agents during the first six months of 2014, and during the same period two years later (2016). A total of 426 and 424 patient encounters, respectively, were documented and collected from the intensive care unit\u2019s electronic patient record system. Daily multidisciplinary ward rounds were conducted for approximately 30\u201340 min, with the goal of optimizing antimicrobial therapy in order to analyze the feasibility of implementing AMS. The only antimicrobial agent which showed a significant reduction in the number of prescriptions and in the duration of treatment during the second audit was vancomycin, while linezolid showed an increase in the number of prescriptions with no significant prolongation of the duration of treatment. A trend of reduction was also seen in the DOT for co-amoxiclavulanate and in the number of prescriptions of anidulafungin without any corresponding increases being observed for other broad-spectrum anti-infective agents (p-values of 0.07 and 0.05, respectively).<\/jats:p>","DOI":"10.3390\/medsci6020040","type":"journal-article","created":{"date-parts":[[2018,5,28]],"date-time":"2018-05-28T03:54:21Z","timestamp":1527479661000},"page":"40","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Feasibility of Antimicrobial Stewardship (AMS) in Critical Care Settings: A Multidisciplinary Approach Strategy"],"prefix":"10.3390","volume":"6","author":[{"given":"Tamas","family":"Tiszai-Szucs","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Critical Care Medicine, St James\u2019s Hospital, P.O. Box 580 Dublin 8, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Mac Sweeney","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care Medicine, St James\u2019s Hospital, P.O. Box 580 Dublin 8, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Keaveny","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care Medicine, St James\u2019s Hospital, P.O. Box 580 Dublin 8, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4878-0256","authenticated-orcid":false,"given":"Fernando A.","family":"Bozza","sequence":"additional","affiliation":[{"name":"Fundacao Oswaldo Cruz, Rio de Janeiro, RJ 37903, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zieta","family":"O. Hagan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care Medicine, St James\u2019s Hospital, P.O. Box 580 Dublin 8, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5834-4063","authenticated-orcid":false,"given":"Ignacio","family":"Martin-Loeches","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care Medicine, St James\u2019s Hospital, P.O. Box 580 Dublin 8, Ireland"},{"name":"Multidisciplinary Intensive Care Research Organization (MICRO), St James\u2019s Hospital, P.O. Box 580 Dublin 8, Ireland"},{"name":"Trinity Centre for Health Sciences, P.O. Box 580 Dublin 8, Ireland"},{"name":"CIBER enfermedades respiratorias, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Cilloniz, C., Martin-Loeches, I., Garcia-Vidal, C., Jose, A.S., and Torres, A. (2016). Microbial etiology of pneumonia: Epidemiology, diagnosis and resistance patterns. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17122120"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jinf.2014.10.004","article-title":"Resistance patterns and outcomes in intensive care unit (ICU)-acquired pneumonia. Validation of European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC) classification of multidrug resistant organi","volume":"70","author":"Torres","year":"2015","journal-title":"J. Infect."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s13613-016-0199-4","article-title":"What\u2019s new in multidrug-resistant pathogens in the ICU?","volume":"6","author":"Zilahi","year":"2016","journal-title":"Ann. Intensive Care"},{"key":"ref_4","unstructured":"Sartelli, M., Kluger, Y., Ansaloni, L., Carlet, J., Brink, A., Hardcastle, T.C., Khanna, A., Chicom-Mefire, A., Rodr\u00edguez-Ba\u00f1o, J., and Nathwani, D. (2017). A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway. Surg. Infect. (Larchmt), 18."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1080\/17512433.2017.1293520","article-title":"Collaborative approach of individual participant data of prospective studies of de-escalation in non-immunosuppressed critically ill patients with sepsis","volume":"10","author":"Leone","year":"2017","journal-title":"Expert Rev. Clin. Pharmacol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Montravers, P., Augustin, P., Grall, N., Desmard, M., Allou, N., Marmuse, J.-P., and Guglielminotti, J. (2016). Characteristics and outcomes of anti-infective de-escalation during health care-associated intra-abdominal infections. Crit. Care, 20.","DOI":"10.1186\/s13054-016-1267-8"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1007\/s00134-016-4341-4","article-title":"Focus on antimicrobial use in the era of increasing antimicrobial resistance in ICU","volume":"42","author":"Bassetti","year":"2016","journal-title":"Intensive Care Med."},{"key":"ref_8","unstructured":"(2018, March 20). Available online: https:\/\/ecdc.europa.eu\/sites\/portal\/files\/documents\/EADD%20EARS-net%20summary.pdf."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Zilahi, G., McMahon, M.A., Povoa, P., and Martin-Loeches, I. (2016). Duration of antibiotic therapy in the intensive care unit. J. 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Care"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Nora, D., Salluh, J., Martin-Loeches, I., and P\u00f3voa, P. (2017). Biomarker-guided antibiotic therapy-Strengths and limitations. Ann. Transl. 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