How is Pseudomonas community-acquired pneumonia (CAP) treated?

Updated: Oct 31, 2019
  • Author: Stephanie L Baer, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

Risk factors for Pseudomonas pneumonia include structural lung disease, COPD, and bronchiectasis. [4] If Pseudomonas is suspected, therapy consists of an anti-pneumococcal and anti-pseudomonal beta-lactam (piperacillin/tazobactam 4.5 g every 6 hours, cefepime 2 g every 8 hours, ceftazidime 2 g every 8 hours, aztreonam 2 g every 8 hours, meropenem 1 g every 8 hours, or imipenem 500 mg every 6 hours.

In patients with severe penicillin allergy, aztreonam may be used instead of the beta-lactam in the regimen listed above. It is worth noting that many reported penicillin allergies are not true allergies. Owing to the limited spectrum of aztreonam and the relatively low likelihood of penicillin allergy cross-reacting with cephalosporins (2%), cefepime is a reasonable choice after considering the balance of benefit and risk. [17]


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