Table 1.

Major themes in antibiotic stewardship in the intensive care unit

• Critical care practitioners are important causes of and potential solutions to the crisis of antibiotic resistance.

• Antibiotic stewardship should be considered a core competency of critical care practitioners.

• Antibiotic stewardship must address the fear of inadequate empirical treatment in the critically ill to be effective.

• The adverse effect of excessive antibiotic treatment on the individual patient needs greater emphasis.

• Antibiotic stewardship programs must ensure that improving overall antibiotic use, not simply reducing antibiotic costs or increasing de-escalation, is the primary focus.

• The hope of rapid diagnostics is currently largely unfulfilled.

• A shift in emphasis to an individualized approach to antibiotic therapy is needed.