Antimicrobial Chemotheraphy of Infections due to Pseudomonas aeruginosa

Aminoglycosides, β-lactam antibiotics such as piperacillin, ticarcillin and mezlocillin, and cefoperazone, cefsulodin and ceftazidime, and imipenem have excellent antipseudomonal activity and have proved useful for the control of Pseudomonas aeruginosa infections. These infections include septicemia, meningitis, pneumonia, urinary tract infection, skin and soft tissue infection and postoperative infection. The aminoglycosides are notable for their synergistic activity with β-lactams, but serum concentrations of aminoglycosides must be carefully monitored to avoid nephrotoxic and ototoxic side effects. Cross-resistance also poses special problems among the aminoglycosides, but amikacin and some dibecacin derivatives are potently active against organisms resistant to other aminoglycosides. Carbenicillin and sulbenicillin are usually given in massive dose because their MICs are high, and this can be detrimental to patients with salt intolerance. Fosfomycin also has a high sodium content. Among the cephalosporins, cefoperazone is expecially effective against biliary tract infection; ceftazidime and cefsulodin are active against Pseudomonas aeruginosa resistant to aminoglycosides. This paper summarizes the antipseudomonal activities of various Kinds of antibiotics and discusses some problems in the actual chemotherapy of Pseudomonas aeruginosa infections.