Antibiotic-resistant Pseudomonas aeruginosa: focus on care in patients receiving assisted ventilation

Abstract

ABSTRACT:  This article discusses ventilator-associated pneumonia caused by Pseudomonas aeruginosa. Ventilator-associated pneumonia caused by P. aeruginosa is one of the leading causes of morbidity and mortality in the intensive care unit, and nowadays it represents a major concern due to the increasing resistance rate of the pathogen to different classes of antibiotics. Here, the choice between a combination therapy and a monotherapy in the empirical setting is analyzed and discussed, by focusing on the recommendations of different published guidelines. Pros and cons of the different possible associations are analyzed and suggestions are given in light of the emergence of multidrug-resistant strains. Route of administration is also discussed, with an emphasis on the use of nebulized antibiotics. Optimal duration of treatment is an additional point of discussion, and explanations are provided for the suggested longer course compared with that of other etiologies.