Selection Criteria & Limiting Factors

Consider the following in selecting the correct antibiotic(s):

1. Host factors — hepatic and renal function

2. Site of infection

3. Antimicrobial sensitivity

4. Drug factors

• Narrow vs wide spectrum, -static vs -cidal, toxicity, costs

Factors limiting antibiotic efficiency include:

1. Poor penetration into site of infection

• Avascular sites
• Diffusion barrier (BBB)
• Intracellular pathogens (TB or Legionella)

2. Obstruction of drainage

• Biliary or GU tracts

3. Presence of foreign body

4. Tissue level factors (acidity)

5. Density of micro-organisms

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