Update in antibiotic therapy in intensive care unit: report from the 2019 Nîmes International Symposium

Marc Leone; Jason A Roberts; Matteo Bassetti; Adrien Bouglé; Jean-Philippe Lavigne; Matthieu Legrand; Michael Neely; José-Artur Paiva; Didier Payen; Jordi Rello; Claire Roger; Fredrik Sjövall; Boris Jung

doi:10.1016/j.accpm.2019.09.009

Update in antibiotic therapy in intensive care unit: report from the 2019 Nîmes International Symposium

Anaesth Crit Care Pain Med. 2019 Dec;38(6):647-656. doi: 10.1016/j.accpm.2019.09.009. Epub 2019 Oct 10.

Authors

Affiliations

¹ Aix-Marseille Université, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Service d'Anesthésie et de Réanimation, Marseille, France. Electronic address: marc.leone@ap-hm.fr.
² University of Queensland Centre for Clinical Research, Faculty of Medicine & Centre for Translational Anti-infective Pharmacodynamics, School of Pharmacy, The University of Queensland, Brisbane, Australia; Departments of Pharmacy and Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia; Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, France.
³ Infectious Diseases Division, Department of Medicine University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy.
⁴ Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire La Pitié-Salpêtrière, Département d'Anesthésie et de Réanimation, Paris, France.
⁵ VBMI, Inserm, U1047, Université Montpellier, UFR de Médecine, and Department of Microbiology, University Hospital Nîmes, Nîmes, France.
⁶ Department of Anesthesia and Perioperative Care, University of California, San Francisco, United States, Inserm U942, INI-CRCT Network, Paris, France.
⁷ Laboratory of Applied Pharmacokinetics and Bioinformatics, The Saban Research Institute, Children's Hospital Los Angeles, and Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, US.
⁸ Department of Intensive Care Medicine-Centro Hospitalar Universitário São João - Faculty of Medicine-University of Porto-Grupo de Infecção e Sepsis, Porto, Portugal.
⁹ University Paris 7 Denis Diderot, Paris Sorbonne Cité, Paris, France.
¹⁰ CIBERES, Instituto Salud Carlos III & Vall d'Hebron Institut of Research, Barcelona, Spain.
¹¹ Department of Anesthesiology and Intensive Care, Pain and Emergency medicine, Nîmes-Caremeau University Hospital, Place du Professeur Robert Debré, 30029 Nîmes cedex 9, France; Physiology Department. EA 2992, Faculty of Medicine, Montpellier-Nimes University, Nîmes, France.
¹² Department of Intensive and perioperative care, Skane University Hospital Malmö, Sweden; Mitochondrial Medicine Department for Clinical Sciences, Lund University, Sweden.
¹³ Département de Médecine Intensive et Réanimation, Inserm U-1046/CNRS U-9234 (PhyMedExp), Hôpital Lapeyronie, Montpellier, France.

PMID: 31606548
DOI: 10.1016/j.accpm.2019.09.009

Abstract

The 2019 Nîmes International Symposium in Antibiotic Therapy Optimisation aimed at determining the best approaches of a number of the antibiotic management strategies for critically ill patients. Experts reviewed the latest literature relating to requirements for an optimal antibiotic stewardship program, risks of sub-therapeutic dosing of antibiotics in critically ill patients, persisting issues about efficiency of combination therapy and the value of de-escalation, new perspectives of pharmacokinetics, drug toxicities including collateral damages-associated with antibiotics, the place of nebulisation of antibiotics, management of patients receiving extracorporeal therapies and the place of new antibiotics. In this paper, each of these issues is discussed with key messages presented after a brief review of evidence.

Keywords: Antibiotics; De-escalation; Dosing; Sepsis; Stewardship.

Publication types

Congress

MeSH terms

Administration, Inhalation
Anti-Bacterial Agents / administration & dosage
Anti-Bacterial Agents / adverse effects
Anti-Bacterial Agents / pharmacokinetics
Anti-Bacterial Agents / therapeutic use*
Antimicrobial Stewardship*
Critical Care
Dose-Response Relationship, Drug
Drug Resistance, Microbial
Drug Resistance, Multiple
Drug Therapy, Combination
Drug Utilization
Drugs, Investigational / therapeutic use
Europe
Extracorporeal Membrane Oxygenation
Forecasting
Humans
Intensive Care Units / statistics & numerical data*
Kidney Diseases / chemically induced
Microbial Sensitivity Tests
Microbiota / drug effects
Nebulizers and Vaporizers
Peripheral Nervous System Diseases / chemically induced
Population Surveillance
beta-Lactams / adverse effects

Substances

Anti-Bacterial Agents
Drugs, Investigational
beta-Lactams