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.