title: Pseudomonas aeruginosa ventilator-associated pneumonia management.
abstract: Ventilator-associated pneumonia is the most common infection in intensive care unit patients associated with high morbidity rates and elevated economic costs; Pseudomonas aeruginosa is one of the most frequent bacteria linked with this entity, with a high attributable mortality despite adequate treatment that is increased in the presence of multiresistant strains, a situation that is becoming more common in intensive care units. In this manuscript, we review the current management of ventilator-associated pneumonia due to P. aeruginosa, the most recent antipseudomonal agents, and new adjunctive therapies that are shifting the way we treat these infections. We support early initiation of broad-spectrum antipseudomonal antibiotics in present, followed by culture-guided monotherapy de-escalation when susceptibilities are available. Future management should be directed at blocking virulence; the role of alternative strategies such as new antibiotics, nebulized treatments, and vaccines is promising.
authors: Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain.
authors: Sergio
authors: S
authors: Ramírez-Estrada
authors: Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain; CRIPS, Vall d'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors: Bárbara
authors: B
authors: Borgatta
authors: Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Centro de Investigación Biomédica en Red Enfermedad Respiratoria - CIBERES, Madrid, Spain.
authors: Jordi
authors: J
authors: Rello
keywords: ICU; adjunctive-therapies; care-bundles; multidrug-resistant; new-antibiotics