Antimicrobial Exposure and the Risk of Delirium in Critically Ill Patients

Jessica J. Grahl; Joanna L. Stollings; Shayan Rakhit; Anna K. Person; Li Wang; Jennifer L. Thompson; Pratik P. Pandharipande; E. Wesley Ely; Mayur B. Patel


Crit Care. 2018;22(337) 

In This Article


In critically ill adult patients with respiratory failure or shock or both, we found that the OR for delirium doubled when patients were exposed to a wide group of first-, second-, and third-generation cephalosporins but not to penicillins, carbapenems, cefepime, fluoroquinolones, or macrolides. Future studies need to be conducted to determine the effect of different classes of antimicrobials on delirium and, in particular, of newer antibiotics, whose use has increased in recent years with the development of multidrug-resistant organisms. At this time, clinicians should remain hesitant about reflexively shifting active antimicrobial strategies simply because of the occurrence of delirium.