García-Lamberechts E J, González-Del Castillo J, Hormigo-Sánchez A I, Núñez-Orantos M J, Candel F J, Martín-Sánchez F J
HOSPITAL CLÍNICO SAN CARLOS.
An Sist Sanit Navar. 2017 Apr 30;40(1):119-130. doi: 10.23938/ASSN.0011.
Infections are one of the main causes of morbidity and mortality in the population. The choice of empirical treatment is one of the most common decisions facing the physician. This first decision has consequences in the prognosis of the patient and the costs associated with the process. This review attempts to summarize the aspects that can lead to failure of antibiotic treatment by considering microbiological and pharmacological aspects, patient profile and infectious focus control. In addition, a series of recommendations are established to minimize this risk, from the point of view of diagnostic accuracy, adequate severity stratification of the patient, knowledge of the pharmacokinetic and pharmacodynamic aspects of antibiotics and control of the infectious focus.
感染是人群发病和死亡的主要原因之一。经验性治疗的选择是医生面临的最常见决策之一。这一初步决策会对患者的预后以及治疗过程的相关费用产生影响。本综述试图通过考虑微生物学和药理学方面、患者情况及感染源控制等因素，总结可能导致抗生素治疗失败的各个方面。此外，从诊断准确性、对患者进行充分的严重程度分层、了解抗生素的药代动力学和药效学方面以及控制感染源的角度出发，制定了一系列建议以将这种风险降至最低。
