Main causes of antibiotic failures... Adapted from Pechère J.C., 1988, 1993, 1998

• False failures

  • erroneous diagnosis
  • underlying disease uninfluenced by antibiotics
  • unjustified lack of patience
  • inactivation of the antibiotic

• Patient related failures

  • compliance failure (broadly speaking)
  • inappropriate administration route (broadly speaking)
  • immunodepressed hosts

• Pharmacological failures

  • insufficient amount or drug inappropriately administered
  • no attention paid to pharmacodynamic parameters
  • in situ inactivation or lack of drainage

• Micro-organism related failures

  • wrong pathogen
  • resistance acquired during treatment
  • insufficient bactericidal activity
  • inoculum effect

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