Antibiotic susceptibility in the surgical intensive care unit compared with the hospital-wide antibiogram.

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Abstract
ANTIBIOTIC resistance is a substantial and growing problem, making the choice of empiric antibiotic therapy increasingly difficult. The potential differences in susceptibility between hospital-acquired and community-acquired infections is widely appreciated, and many clinicians choose initial empiric therapy based on this distinction. Susceptibility of microorganisms causing community-acquired infections is known to vary between geographic locales, while susceptibility of bacterial isolates causing hospital-acquired infections may vary widely among hospitals within the same geographic locale. The application of hospital-wide antibiograms to guide clinicians in the initial choice of antibiotics is a rational and recommended approach, given the differences in susceptibility patterns between hospitals.1 However, susceptibility patterns may vary among individual hospital units. If more resistant organisms are isolated from patients in the intensive care unit (ICU) but not in other hospital units, then this important information could be masked by the use of a hospital-wide antibiogram.2

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