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Antibiotics: Why They Fail in Patients Who Are Critically III

Most of the failures of antimicrobial therapy can be related to advanced infections in patients with serious comorbid processes or altered immunity. However, some of the failures are related to the type of antimicrobial therapy used, the length of therapy, the pharmacokinetic or pharmacodynamic properties of the antimicrobial agent, the development of antimicrobial resistance, microbial factors that influence antimicrobial efficacy, and the site and type of infection. This report will review the common mechanisms by which antimicrobials fail.