Discussing the appropriateness of antimicrobial treatment and multidrug-resistant organisms: a six-month flash insight on infections occurring in the ICU

Increasing numbers of infections from multi-drug-resistant organisms constitute a rising worldwide emergency with possible severe consequences to the public health [1]. Certain hospital wards, such as the intensive care unit, are among the most involved. In fact, despite accounting for a relative small number of total hospital beds, a large number of nosocomial infections are acquired in the ICU and are an important cause of morbidity and mortality [2][3]. These infections are mostly related to the increased use of invasive devices (e.g., mechanical ventilators, urinary catheters, or central venous catheters) and the admission of already critical patients with multiple comorbidities, which may not only be immunologically compromised, but also admitted carrying important infections (SEPSIS). Multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA) and others, are increasingly isolated from the ICU further complicating survival and treatment (e.g. limited drug choice options) [4][5] and worsen the outcome markedly in terms of length of hospital stay, increased mortality, and hospital costs [6][7]. Adequate antimicrobial management including adherence to antibiotic stewardship protocols and various strategies minimising unnecessary antibiotic use, along with other prevention strategies thus seems paramount, since they have proven to reduce resistant infections [8]. We hence believe that an accurate assessment of the present antibiotic stewardship strategies in place at the Intensive Care Units 1 & 2 in Policlinico San Matteo, discussing its appropriateness may provide valuable data and accentuate possible areas of improvement. Aim of the study The main goal is to ponder the present antibiotic stewardship strategy applied in the ward under observation, discussing its appropriateness in infection control.