The effects of hand-washing, restrictive antibiotic use and SDD on morbidity

Abstract

Considerable numbers of critically ill patients suffer from infections during their stay in the intensive care unit (ICU), as outlined in Chapter 3. The most common infections in these patients are lower respiratory tract infections (e.g., ventilator-associated pneumonia; VAP), followed by infections of the urinary tract and bloodstream infections [1]. The treatment of infections in critically ill patients is difficult. First, a steady increase in the prevalence of antibiotic resistance among microorganisms has made the treatment of infections more complex [2] and no breakthroughs for new antibiotic classes are in sight at present. Secondly, although it is speculated that the high incidence of infections in critically ill patients may be the result of the underlying disease and/or immunoparalysis (as may develop in the course of sepsis), therapy aimed at modulation of the immune response during infection is further from clinical practice than before [3, 4]. The prevention of infection and control may be a more effective strategy in intensive care medicine than the treatment of infections. © 2008 Springer-Verlag Italia.