A systematic review on de-escalation of antibiotics uses in surgical patients in clinical sepsis

Himanshu sehrawat 1, *, Junaid Tantray 1, Sourabh Kosey 2, Himanshi 1, Jyoti Jwala 1, Irfan Hussain Khan 3 and Sohil 1

1 NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, Rajasthan, India.
2 NIMS Institute of Pharmacy, NIMS University Rajasthan, Jaipur, Rajasthan, India.
3 National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India. 
 
Review Article
World Journal of Advanced Research and Reviews, 2023, 18(01), 459–468
Article DOI: 10.30574/wjarr.2023.18.1.0608
 
Publication history: 
Received on 27 February 2023; revised on 09 April 2023; accepted on 11 April 2023
 
Abstract: 
Antimicrobial resistance is a feature of the current topography of clinical sepsis, and in the future, fewer and fewer new antibiotics, especially those from novel classes1, will be developed to address these problems. Effective antimicrobial treatment is necessary to ensuring good patient outcomes. Increased duration of stay, multidrug-resistant infections, and death can result from improper or inefficient use of antibiotics. Patients in intensive care who are critically sick are at risk for antibiotic failure and secondary infections brought on by improper antibiotic usage, especially those with severe sepsis and septic shock. Providers can speed up the treatment of common intensive care unit (ICU) infections by starting active empiric antibiotic therapy based on local susceptibilities, daily review of infection signs and symptoms, and, where practical, restricting antibiotic therapy. Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat. Early detection of septic patients enables the use of evidence-based therapies, including goal-directed resuscitation, rapid antibiotic administration, and activated protein C. It may be simpler to provide appropriate care for sepsis if this clinical entity is divided into several phases and new delivery structures that span traditional boundaries are implemented. More specialized treatments will be possible with a better understanding of the molecular underpinnings of the illness process.
 
Keywords: 
Antimicrobial; Antimicrobial Resistance; Multi Drug Resistance; Global Action Plan; Antimicrobial Stewardship Programme; Intensive Care Unit; Center for Disease Control; Septic Shock
 
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