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Approach to the Treatment of Patients with Serious Multidrug‐Resistant Pseudomonas aeruginosa Infections
Author(s) -
O'Donnell, J. Nicholas,
Bidell, Monique R.,
Lodise Thomas P.
Publication year - 2020
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.2449
Subject(s) - pseudomonas aeruginosa , medicine , intensive care medicine , multiple drug resistance , tazobactam , empiric therapy , antibiotics , ceftazidime/avibactam , ceftazidime , antibiotic resistance , imipenem , microbiology and biotechnology , biology , bacteria , genetics
Multidrug resistance(MDR) among Pseudomonas aeruginosa (PSA) isolates presents a significant clinical challenge and can substantially complicate the approach to selection of optimal antibiotic therapy. This review addresses major considerations in antibiotic selection for patients with suspected or documented serious MDR‐PSA infections. Common mechanisms contributing to MDR among clinical PSA isolates are summarized. Empiric and definitive therapy considerations are addressed including the potential role of combination therapy. Newer agents with in vitro activity against MDR‐PSA (e.g., ceftolozane‐tazobactam, ceftazidime‐avibactam, imipenem‐relebactam, and cefiderocol) and their potential roles in clinical settings are discussed. Although these newer agents are promising options for the treatment of MDR‐PSA, clinical data remain generally limited. Future studies are needed to determine optimal agents for the empiric and definitive treatment of MDR‐PSA.