Antimicrobial Treatment of Pseudomonas aeruginosa Severe Sepsis

Abstract

Pseudomonas aeruginosa is a pathogen often encountered in a healthcare setting. It has consistently ranked among the most frequent pathogens seen in nosocomial infections, particularly bloodstream and respiratory tract infections. Aside from having intrinsic resistance to many antibiotics, it rapidly acquires resistance to novel agents. Given the high mortality of pseudomonal infections generally, and pseudomonal sepsis particularly, and with the rise of resistant strains, treatment can be very challenging for the clinician. In this paper, we will review the latest evidence for the optimal treatment of P. aeruginosa sepsis caused by susceptible as well as multidrug-resistant strains including the difficult to treat pathogens. We will also discuss the mode of drug infusion, indications for combination therapy, along with the proper dosing and duration of treatment for various conditions with a brief discussion of the use of non-antimicrobial agents. © 2022 by the authors.

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Keywords

Antibiotics, Antimicrobial resistance, Hospital-acquired infections, Pseudomonas aeruginosa, Severe sepsis, Antibiotic agent, Avibactam plus ceftazidime, Bacteriocin, Cefiderocol, Ceftolozane plus tazobactam, Cilastatin sodium plus imipenem plus relebactam, Colistin, Fosfomycin, Plazomicin, Vaccine, Antibiotic resistance, Antimicrobial therapy, Artificial ventilation, Bacteremia, Bacterial clearance, Carbapenem resistant pseudomonas aeruginosa, Carbapenemase producing enterobacteriaceae, Drug infusion, Extended spectrum beta lactamase producing enterobacteriaceae, Hospital infection, Hospital mortality, Hospitalization, Human, Infectious agent, Infusion rate, Intensive care unit, Length of stay, Minimum inhibitory concentration, Phage therapy, Pharmacokinetic parameters, Phenotype, Pseudomonas infection, Pseudomonas pneumonia, Quorum sensing, Review, Sepsis, Treatment duration

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