Selection pathogen factors

Use of penicillin and the tetracyclines also causes selection for pathogenicity factors, that is, disease-causing factors. These factors and drug resistance have been shown to be linked on the same plasmid. Pathogenicity and antibiotic resistance can therefore be transferred simultaneously to other organisms. 

Second, herbs that expel exterior pathogenic factors and remove dampness and phlegm are selected. 

Appropriate empiric anti-infective therapy decreases 28-day mortality compared to inappropriate empiric therapy (24% versus 39%).22 23,30 Additionally, appropriate therapy administered within 1 hour of sepsis recognition also decreases complications and mortality.22-23,30 Empiric anti-infective therapy should include one, two, or three drugs, depending on the site of infection and causative pathogens (Table 79-3). Anti-infective clinical trials in sepsis and septic shock patients are scarce and have not demonstrated differences among agents therefore, factors that determine selection are ... 

A variety of factors may be responsible for apparent lack of response to therapy. It is possible that the disease is not infectious or nonbacterial in origin, or there is an undetected pathogen. Other factors include those directly related to drug selection, the host, or the pathogen. Laboratory error in identification and/or susceptibility testing errors are rare. 

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