Empiric selection of antibiotics

Infection in the critical care unit is a common and important cause of prolongation of hospital stay, morbidity, and mortality. The era of antimicrobial therapy has provided us with a rapidly expanding armamentarium of powerful drugs to treat these infections more effectively than ever before, but these drugs have come at a cost of resistant organisms, rising expenditures, and drug toxicity. Antibiotic selection is more difficult because of the emergence of resistant organisms, a multiplicity of drugs available with overlapping activity, and an era of cost-consciousness. Thoughtful consideration of the most likely etiologic agents, clinical status of the patient, and drug characteristics can lead to selection of an optimal therapeutic agent.