SCCM Resource Library-Fermenting on a Decision: Best Practices for Providing Empiric Anaerobic Antibiotic Coverage in the ICU

Fermenting on a Decision: Best Practices for Providing Empiric Anaerobic Antibiotic Coverage in the ICU

Video Transcription

Video Summary

The speaker, Kevin Betthauser, discussed the topic of ICU-induced dysbiosis and the role of anti-anaerobic antibiotics in aspiration pneumonia. He highlighted the importance of the microbiome in protecting against colonization by pathogens and its role in disease states commonly encountered in the ICU. He also mentioned various contributors to ICU-induced dysbiosis, including antibiotics, proton pump inhibitors, vasopressors, opioids, and total parenteral nutrition. Betthauser discussed the historical use of anti-anaerobic antibiotics in aspiration pneumonia and the changing landscape of their utilization. He presented a study that showed a reduction in the use of anti-anaerobic antibiotics over the years but also highlighted the need for further improvement. He mentioned a retrospective cohort study that compared clinical outcomes and respiratory microbiology in patients who received and did not receive anti-anaerobic antibiotics. The study showed a higher VAP-free survival in patients who did not receive anti-anaerobic antibiotics. Betthauser emphasized that current evidence does not support routine use of anti-anaerobic antibiotics in critically ill patients with pneumonia and suggested reserving their use for confirmed or highly suspected anaerobic infections.

Asset Subtitle

Quality and Patient Safety, Pharmacology, 2023

Asset Caption

Type: two-hour concurrent | Treatments on Autopilot (SessionID 1119558)

Meta Tag

Content Type Presentation

Knowledge Area Quality and Patient Safety

Knowledge Area Pharmacology

Membership Level Professional

Membership Level Select

Tag Antibiotics

Tag Evidence Based Medicine

Year 2023

Keywords

ICU-induced dysbiosis

anti-anaerobic antibiotics

aspiration pneumonia

microbiome

disease states

contributors to dysbiosis

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