Treatment, Prevention and Control of Pseudomonas aeruginosa Infections

Treatment

Treatment of Pseudomonas infection is by specific antimi-crobial therapy. However, P. aeruginosa shows a considerable degree of resistance to many of the commonly used antibiotics. Pseudomonas are susceptible to cefotaxime, ceftazidime, gen-tamicin, tobramycin, carbenicillin, azlocillin, and ticarcillin. Ciprofloxacin is most frequently used antibiotic, because it is active against P. aeruginosa in most tissues. Pseudomonas infec-tions are treated best with combination of at least two antip-seudomonal antibiotics. A combination of aminoglycosides or quinolone with another antipseudomonal antibiotic is effec-tive for most of the Pseudomonasinfections.

Treatment with a combination of two antibiotics is usually not recommended for single urinary tract infection, local skin infection, or in febrile leukopenic patients.

Treatment with hyperimmune globulin and granulocytic trans-fusion may be useful. Treatment of underlying diseases and appropriate supportive therapy is also crucial for treatment of pseudomonal infections.

Prevention and Control

Prevention of Pseudomonas infections, particularly in hospitals, is always difficult. It requires constant monitoring and strict attention to asepsis. The measures suggested for hospital infec-tion control practices are based on:

1.        Prevention of cross-infection of patients by attending med-ical and paramedical personnel.

2.        Prevention of contamination of equipments, such as dialy-sis machine and respiratory instruments and restricting the use of broad-spectrum antibiotics. The latter suppresses normal microbial flora and facilitates the overgrowth of resistant Pseudomonasorganisms.

3.        Pseudomonas vaccines have been evaluated in specializedsituation, such as cases of cystic fibrosis that are highly susceptible toPseudomonas infections.