Échec de l'antibiothérapie en réanimation

Antibiotic administration and treatment response assessment are common practice in ICUs. During a bacterial infection, the host, the bacteria, the site and the antibiotic are the determinants of the evolution of the infectious process. The definition of antibiotic failure should thus be adapted, in terms of criterion and delay, according to the combination of these elements. Each one can therefore be involved in the failure (defenses of the host, bacterial resistance, accessibility of the site, adapted therapeutic diagram). Only a rigorous approach allows, after having confirmed diagnosis and eliminated false failures, to systematically screen and determine the mechanism involved in these failures.