Conservative initiation of antimicrobial treatment in ICU patients with suspected ICU-Acquired infection: More haste less speed

PURPOSE OF REVIEW: To review the recent literature supporting the idea that in some patients suspected of having a new ICU-Acquired infection, antibiotics can be withheld until evidence to confirm diagnosis is obtained. RECENT FINDINGS: Recent publications demonstrate that in community-Acquired pneumonia, severe sepsis presenting to the emergency room, and suspected ICU-Acquired infection, the time to antibiotic therapy does not necessarily seem to be a key determinant of outcome. SUMMARY: In the ICU, patients without septic shock but suspected of having an ICU-Acquired infection may be able to have antibiotics withheld until infection is confirmed using a combination of laboratory, radiologic, and microbiological data.