Reasons for Failure of Antibacterial Therapy



Reasons for Failure of Antibacterial Therapy
1) The diagnosis was incorrect, eg, viral and not bacterial infection.
2) The organisms were not susceptible to the action of the antibiotic that was selected, or they were in static phase and therefore refractory (“persisters”).
3) Although originally susceptible, the bacteria developed resistance.
4) The antibiotic(s) was insufficient for multiple pathogens.
5) A combination of incompatible antibiotics was administered.
6) Superinfection by a resistant opportunistic pathogen occurred.
7) Reinfection by the original or by other pathogenic bacteria occurred.
8) Drainage was inadequate in surgical infections, or a foreign body was present.
9) Perfusion and penetration to the site of infection were impaired because of inflammation, cellular debris, tissue destruction, abscessation, etc.
10) The organism is intracellular in location and able to avoid detrimental effects by phagocytic cells.
11) Defense mechanisms (specific and nonspecific) of the animal were compromised by disease, malnutrition, or concurrent therapy.
12) Detrimental changes, such as hypoxia, acidosis, or accumulation of tissue debris, developed in infected tissue, which reduced the effectiveness of the antibiotic or sulfonamide.
13) An inappropriate route of administration was selected or an incorrect dosage regimen was followed because the pharmacokinetic characteristics of the antimicrobial drug were not appreciated.
14) Expired or substandard products were used.
15) The selected agent had to be withdrawn because of adverse effects.
16) Interaction of the selected antimicrobial agent(s) with other concurrently administered drugs occurred, which diminished the antimicrobial effect or altered the pharmacokinetics of the agent(s).
17) The prescribed dosage regimen was not reliably followed (lack of owner compliance).
18) Supportive therapy was inadequate.
19) Nutritional deficits were not corrected.
20) Nursing care was substandard, and the stress associated with the disease process was not reduced.
21) Predisposing management factors were not corrected.

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