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Review
. 2020 Sep;40(9):952-969.
doi: 10.1002/phar.2449. Epub 2020 Aug 17.

Approach to the Treatment of Patients with Serious Multidrug-Resistant Pseudomonas aeruginosa Infections

J Nicholas O'Donnell  1 , Monique R Bidell  2 , Thomas P Lodise  1
Affiliations
Review

Approach to the Treatment of Patients with Serious Multidrug-Resistant Pseudomonas aeruginosa Infections

J Nicholas O'Donnell et al. Pharmacotherapy. 2020 Sep.

Abstract

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.

Keywords: Pseudomonas aeruginosa; multidrug resistance; pharmacodynamics.; pharmacokinetics.

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References

    1. Diekema DJ, Hsueh PR, Mendes RE, et al. The microbiology of bloodstream infection: 20-year trends from the SENTRY Antimicrobial Surveillance Program. Antimicrob Agents Chemother 2019;63(7):e00355-19.
    1. Weiner LM, Webb AK, Limbago B, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the national healthcare safety network at the centers for disease control and prevention, 2011-2014. Infect Control Hosp Epidemiol 2016;11:1288-301.
    1. Livermore DM. Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: our worst nightmare? Clin Infect Dis 2002;5:634-40.
    1. Moradali MF, Ghods S, Rehm BH. Pseudomonas aeruginosa lifestyle: a paradigm for adaptation, survival, and persistence. Front Cell Infect Microbiol 2017;7:1-29.
    1. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;3:268-81.

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