Causes of Antibiotic Failure - Differential Diagnosis ...
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Description

Causes of Antibiotic Failure - Differential Diagnosis Framework
Diagnosis:
 • Non-Infectious: Malignant, Autoimmune, Drug-related (NMS, serotonin syndrome, antichol, toxin), Tissue Inflammation (pancreatitis), Drug withdrawal, Pseudo-cellulitis / "CAP" mimic, VTE
 • Wrong Bug: Atypical bacteria: Viral, Fungal, Parasite
Natural History:
 • Too Soon: Can take 48 hrs for infections to improve
 • Too Aggressive: MRSA bacteremia, Toxin-mediated, Ongoing source
 • Predisposition to Infections: Obstruction/Anatomical abnormality, Aspiration, Immunocompromise
Treatment:
 • Antibiotic: Spectrum (MRSA/ESBL), Not taking/absorbing? Wrong dose?
 • Tissue: Source control (abscess, lines, osteo, endocarditis), Tissue penetration (CNS, prostate, ocular), Tissue activity (daptomycin in lungs)
Mimics / Secondary Process:
 • Secondary to Treatment: Drug side effect/reaction (ie SJS, DIHS, drug fever, Jarish Herxheimer rxn), Secondary infection (C diff)
 • Hospital-Acquired Infection: IV catheter (CLABSI or thrombophlebitis), HAP, Blood stream, C. Difficile, COVID-19
 • Unrelated Infection: Esp in immunocompromised hosts

Dr. Ann Marie Kumfer @AnnKumfer

#Antibiotic #Failure #Differential #Diagnosis 
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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