José Luis Del Pozo, Department of Clinical Microbiology, Clínica Universidad de Navarra, Pamplona, Spain.
Rev Esp Quimioter. 2023 Nov;36 Suppl 1(Suppl 1):54-58. doi: 10.37201/req/s01.13.2023. Epub 2023 Nov 24.
Pseudomonas aeruginosa is a pathogen that has a high propensity to develop antibiotic resistance, and the emergence of multidrug-resistant strains is a major concern for global health. The mortality rate associated with infections caused by this microorganism is significant, especially those caused by multidrug-resistant strains. The antibiotics used to treat these infections include quinolones, aminoglycosides, colistin, and β-lactams. However, novel combinations of β-lactams-β-lactamase inhibitors and cefiderocol offer advantages over other members of their family due to their better activity against certain resistance mechanisms. Selecting the appropriate empiric antibiotic treatment requires consideration of the patient's clinical entity, comorbidities, and risk factors for multidrug-resistant pathogen infections, and local epidemiological data. Optimizing antibiotic pharmacokinetics, controlling the source of infection, and appropriate collection of samples are crucial for successful treatment. In the future, the development of alternative treatments and strategies, such as antimicrobial peptides, new antibiotics, phage therapy, vaccines, and colonization control, holds great promise for the management of P. aeruginosa infections.
铜绿假单胞菌是一种具有高度抗生素耐药性倾向的病原体，多药耐药株的出现是全球健康的主要关注点。由这种微生物引起的感染相关死亡率很高，特别是由多药耐药株引起的感染。用于治疗这些感染的抗生素包括喹诺酮类、氨基糖苷类、粘菌素和β-内酰胺类。然而，由于对某些耐药机制的活性更好，β-内酰胺类-β-内酰胺酶抑制剂和头孢地尔的新型组合比其家族中的其他成员具有优势。选择合适的经验性抗生素治疗需要考虑患者的临床实体、合并症和多药耐药病原体感染的危险因素，以及当地的流行病学数据。优化抗生素药代动力学、控制感染源和适当采集样本对于成功治疗至关重要。在未来，替代治疗和策略的发展，如抗菌肽、新型抗生素、噬菌体治疗、疫苗和定植控制，为铜绿假单胞菌感染的管理带来了巨大的希望。
