Match the Bug to the Drug

• If fever is the patient’s only sign of infection, the patient should not automatically be placed on an antibiotic.

• For treatment of a presumed infection, appropriate diagnostic tests, such as cultures, should always be done before starting treatment with antibiotics.

• A single drug and the most narrow-spectrum drug or drugs should be used whenever possible, especially if the infecting organism or organisms are known at the outset.

• Reassess the need for continued antimicrobial therapy daily and modify therapy based on culture results.

• Don’t extend surgical antimicrobial prophylaxis beyond 24 hours postoperatively. Patients undergoing most surgeries can receive a single dose of preoperative antibiotic.

Source: Maki DG. "Nosocomial Infection in the Intensive Care Unit." In: Parrillo JE, Bone RC, eds. Critical Care Medicine: Principles of Diagnosis and Management. St. Louis: Mosby Year Book Inc.; 1995, pp. 893-954.