How to break the vicious circle of antibiotic resistances?

PURPOSE OF REVIEW: To review the new findings on the use of antibiotics in the ICU patients. RECENT FINDINGS: Although there are several lines of evidence for a prompt use of antibiotics in life-threatening infections, restricting the use of antibiotics should remain the common rule. In order to reduce the emergence of multiresistant bacteria, several approaches have been tested: knowledge of local ecology, choice of the best dose of antibiotics based on their pharmacokinetic and pharmacodynamic properties, de-escalation after results of cultures, and shortening the duration of treatment. An integrative strategy including all these approaches could be associated with a reduced incidence of multiresistant bacteria. SUMMARY: Good evidence suggests that a strategy aiming at reducing the prolonged use of broad-spectrum antibiotics is the only mean to reduce the emergence of multiresistant bacteria.