Failure of Antibiotic Therapy

Abstract

The reasons for failure to achieve the goal of antibiotic treatment can be summarised under three headings:

• 1. The Patient • Weakened autoimmune defence system (cytostatic therapy, cancer, diabetes, alcoholism, liver cirrhosis, etc.); foreign bodies (intravenous catheter, bladder catheter, hydrocephalus valve, tracheal tube)

• Abscess or poorly accessible infection site

• Drug fever (fever does not subside!)

• The patient does not take the antibiotic (up to 30%!)

• 2. The Pathogen • The microbe isolated is not the cause of infection (incorrect sampling, incorrect transport, polymicrobial infection)

• Viral infection, fungal infection!

• Mixed infection, or the isolated bacterium is only a contaminant

• Superinfection (hospital infection, fungi!)

• Development of resistance (relatively infrequent)

• Selection of resistant portions of the pathogen population

• Change of pathogen during therapy (especially fungal infection)