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Editorials |

Toward a More Thoughtful Approach to Fever in Critically Ill Patients

Constantine A. Manthous, MD, FCCP
Author and Funding Information

Affiliations: Bridgeport, CT 
 ,  Dr. Manthous is Assistant Clinical Professor of Medicine, Divisions of Pulmonary and Critical Care, Bridgeport Hospital and Yale University School of Medicine.

Correspondence to: Constantine A. Manthous, MD, FCCP, Bridgeport Hospital, 267 Grant St, PO Box 5000, Bridgeport, CT 06610; email: pcmant@bpthosp.org



Chest. 2000;117(3):627-628. doi:10.1378/chest.117.3.627
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In this issue of CHEST (see page 855), Dr. Paul Marik presents a clinical approach to fever in critically ill patients. This concise review reiterates that all fevers are not necessarily caused by infections and presents a reasonable, albeit not evidence-based, algorithm for approaching this common clinical problem. At some hospitals, intensivists and infectious disease physicians may differ in their general approaches to fever in the ICU. There appears to be a pervasive notion that intensivists administer antibiotics, and particularly powerful broad-spectrum antibiotics, more liberally than infectious disease (ID) experts. I am unaware of any data to support this contention. Nonetheless, if this is true, and it is reasonable for each of us who practices critical care medicine to contemplate, we may be contributing to the problem of multidrug resistance, a modern plague in the ICU. It is also worthwhile for us to think about why it may be so (if it is).

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