Which medications are used in the treatment of Pseudomonas infections?

Updated: Dec 17, 2018
  • Author: Selina SP Chen, MD, MPH; Chief Editor: Russell W Steele, MD  more...
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Answer

Pseudomonas should be considered in the differential diagnoses in any probable Gram-negative infections. Often, the effect of this organism causes concern because it can cause severe hospital-acquired infection, especially in immunocompromised hosts. Furthermore, a concomitant antibiotic resistance is often present, which makes the choice of treatment difficult.

Often, treatment initially consists of empiric antibiotics. Therefore, when treating Pseudomonas organisms, one must consider some basic concepts. Indwelling catheters associated with any infections should be promptly removed. Delays in treatment are associated with high mortality. Combination therapy needs to be initiated in patients with severe infections and high-risk patients. Combination therapy requires 2 antipseudomonal antibiotics, each with different mechanisms of action. Often, treatment is achieved with a combination of an aminoglycoside or quinolone with another antipseudomonal antibiotic.

Combination therapy with antipseudomonal antibiotics is used to ensure treatment of resistant strains and to prevent selection of resistant mutants. Carbapenems (eg, imipenem, meropenem) and the monobactam antibiotic aztreonam are generally reserved for serious infections caused by organisms resistant to other beta-lactam antibiotics or in those with renal disease who are at risk for aminoglycoside-related nephrotoxicity.


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