Duration of antibiotic treatment in intensive care patients: current data.

Objective: To review the current data on the duration of an antibiotic trea tment. Methods: Analysing of recent and older articles on criteria of discontinuat ion of an antibiotic treatment in intensive care patients. Synthesis: In intensive care patients the initiation of an antibiotic thera py is mor or less codified, in spite of numerous existing problems. The dur ation of its maintenance, although based on scientific data depends mainly on a multitude of variables. The first step is to assess the therapeutic ef ficiency in considering the regression of clinical manifestations, the norm alization of the acute phase reactants, the sterility of bacteriological sa mples and the absence of relapse at therapy discontinuation. An assessment after 48 hours is essential, in order to decide the maintenance or the modi fication of therapy. Finally the indication of bitherapy is considered. The theoretical duration of antibiotic therapy is determined in taking into ac count the involved microbial agent(s), the centre of infection, the bacteri al inoculum, the patient, the presence of foreign material, and the adminis tered antibiotic. (C) 2000 Editions scientifiques et medicales Elsevier SAS .