Antibiotic resistance in the intensive care unit

The use of antibiotics is unique in medical practice in that the treatment given to an indi-vidual may have consequence for the wider population. Pathogens may be intrinsically resistant to antibiotics, but the problem of induced or evolving resistance should not to be underestimated. Increasingly, it is recognized that the use of broad-spectrum agents, even when appropriate, is a significant factor in the development of resistance in bacteria and fungi. This has major implications for health-care in general, and particularly in the ICU where resistant organisms can present major challenges, as patients tend to be debilitated and particularly susceptible to nosocomia