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Gram-Negative Resistance in the Intensive Care Unit

Medical Intensive Care Unit, Rush University Medical Center, Department of Pharmacy, Section of Pulmonary and Critical Care Medicine, Chicago, Illinois

Christopher W. Crank, PharmD, BCPS

Rush University Medical Center, Department of Pharmacy, Chicago, Illinois

Gram-negative resistance is an increasingly important consideration when initiating empiric antimicrobial therapy in intensive care units. Infection with a resistant organism has been associated with increased morbidity and mortality as well as increased hospital cost. Gram-negative resistance in intensive care units will likely continue to increase. Clinicians must aggressively manage infections in the intensive care unit while practicing the appropriate steps to minimize future resistance. This review article summarizes the epidemiology, risk factors, mechanisms of resistance, and management of infections due to resistant gram-negative organisms.

Key Words: Gram-negative • resistance • intensive care unit • antimicrobial • mechanism

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