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Semin Respir Crit Care Med 2007; 28(6): 656-661
DOI: 10.1055/s-2007-996412
© Thieme Medical Publishers

Optimizing Antipseudomonal Therapy in Critical Care

Jonathan R. Iredell1
  • 1Centre for Infectious Diseases and Microbiology, University of Sydney/Westmead Hospital, Westmead, Australia
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Publication History

Publication Date:
20 December 2007 (online)

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ABSTRACT

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.

KEYWORDS

Pseudomonas aeruginosa - antibiotic resistance - biofilm - quorum sensing - therapy - bacteriophage

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Jonathan R IredellM.B. B.S. Ph.D. 

Centre for Infectious Diseases and Microbiology

Level 3 ICPMR Bldg., Westmead Hospital, Westmead NSW 2145 Australia

Email: Jon.Iredell@swahs.health.nsw.gov.au

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