Intensive care unit antimicrobial resistance and the role of the pharmacist

Over the past 20 yrs, pharmacists have successfully integrated their servic es and expertise to gain acceptance as full members of pediatric, surgical, medical, and intensive care unit (ICU) patient care teams, The pharmacists ' training in pharmacology, pharmacokinetics, pharmacodynamics, and pharmac oeconomics complements the expertise of other members of the patient care t eam. Generally, a strong background in infectious diseases and critical car e also provides a focal point for clinical pharmacy service intervention. A lthough practitioners often focus on issues exclusively related to their sp ecific hospital or ICU, the issues surrounding antibiotic resistance are mo re global and societal in nature. Medical, surgical, and pharmaceutical pra ctices inside the hospital and ICU extend their influence into the communit y. Customs and practices of daily living in our society coupled with use of agents capable of altering microbial flora impact our hospital and ICU whe n patients from the community are admitted. The misuse of antibiotics and t he lack of effective infection control programs are often identified as key components in the perpetuation of these phenomena, The focus for the pharm acist and the ICU team must be on the optimization of antibiotic use and in fection control guidelines. This review will address the many issues that s urround the appropriate use of antibiotics and what role the pharmacist can play in ensuring the optimal use of infection control measures in the ICU and hospital.