Optimizing antipseudomonal therapy in critical care.
Pseudomonas aeruginosa is a common and important pathogen in the critically ill. It combines environmental hardiness with genomic plasticity and is well adapted to the various niches available in the intensive care unit (ICU). Unresolved arguments over the value of dual versus monotherapy relate primarily to rapidity of killing and to the avoidance of therapeutic failure due to antibiotic resistance. Increasing resistance to conventional antibiotics means that we need to be aware of the factors that promote the success of this pathogen in the ICU, and of emerging alternative strategies. This review focuses on an understanding of the underlying issues and on the practical aspects of prescribing, particularly in the ICU.
Iredell
Jonathan R
JR
Centre for Infectious Diseases and Microbiology, University of Sydney/Westmead Hospital, Westmead, NSW 2145, Australia. Jon.Iredell@swahs.health.nsw.gov.au
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003550:Cystic Fibrosis / Q000382:microbiology; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D004359:Drug Therapy, Combination; D006801:Humans; D007362:Intensive Care Units; D011552:Pseudomonas Infections / Q000188:drug therapy*; D017105:Pseudomonas Phages; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000472:pathogenicity; D053038:Quorum Sensing
D000900:Anti-Bacterial Agents