Remediable Causes of Failure of “Appropriate” Antimicrobial Therapy

Abstract

Emergence of genotypic drug resistance, commonly blamed for failure of seemingly appropriate antimicrobial therapy, actually accounts for a minority of such failures. More often, the host, microorganisms, and pharmacologic factors interact to inhibit drug action. Foreign body, abscess, and obstructed drainage are recognized remediable situations that also predispose to “microbial indifference” to agents that ordinarily would be effective.