5.2 Treatment does not depend only on laboratory results

It is essential to report results to clinicians appropriately and accurately – but this cannot replace clinical judgement.

The clinician must consider patient-specific factors. For example, if a patient is not responding to the treatment despite the laboratory report indicating that the bacteria causing the infection are susceptible to the recommended antimicrobial agent, there are several possible reasons:

• It could be behavioral: the patient may not be following the instructions and is not taking medications as recommended.
• The patient could be taking a substandard or falsified medicine. Medicines should always be acquired from a reputable source.
• The site of the infection is important: for example, an abscess may require surgical drainage.
• Have you identified and controlled the source of infection? If the source is determined, it may be possible to control the infection by surgical removal. In some cases, the removal of infected intravenous or urinary catheters will control the source and no antibiotic treatment will be required.
• For some infections, such as enteric fever, it takes a few days (72 hours) for the fever to settle after beginning the treatment. Time is required not only for antimicrobial treatment to take effect but for the patient’s immune response to be activated.