General principles of antimicrobial therapy.

Antimicrobial agents are appropriate treatment for acute, severe, persistent, or progressive infectious diseases. The efficacy of treatment depends on the accuracy of the diagnosis of infection and the appropriateness of the antimicrobial agent for the causative microorganism. In this symposium, the antimicrobial agents reviewed correspond with the bacterial, fungal, viral, mycobacterial, parasitic, chlamydial, and other microorganisms that cause disease in humans. Usually, the etiologic possibilities can be limited on the basis of the history and physical examination, laboratory tests, or results of treatment trials. Many of the same findings, however, can result from noninfectious, other inflammatory, or unknown mechanisms. Manifestations such as fever and organ dysfunction are nonspecific and often not caused by an infectious process. Even when infection is clinically apparent, the causative microorganism may not be identified, and empiric treatment with broad-spectrum agents is appropriate in many cases of serious disease.