Antibiotic therapy for Pseudomonas aeruginosa bacteremia: Outcome correlations in a prospective study of 200 patients

Population-Based Study of the Epidemiology and the Risk Factors for Pseudomonas aeruginosa Bloodstream Infection

“…However in unselected patient series this mortality rate appears to be more stable at 30-40%, suggesting that bias exists in centers with specific medical focus [3,4,20]. The overall mortality in our population-based study of P. aeruginosa BSI of 29% is similar to that reported in two other population-based Figure 3.…”

“…Considerable variation in P. aeruginosa BSI-associated mortality has been reported in recent series (18-61%) [4,10,11,13,40]. However in unselected patient series this mortality rate appears to be more stable at 30-40%, suggesting that bias exists in centers with specific medical focus [3,4,20].…”

“…Pseudomonas aeruginosa bacteremia is associated with the one of highest mortality rates among bacterial nosocmial blood stream infections (BSIs) (18-61%) [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. While numerous series have been published describing risk factors associated with P. aeruginosa bacteremia, these have mainly been restricted to community [13] and tertiary care referral hospitals [6, 10-12, 14, 15] or to special populations, such as pediatric patients [16], patients in intensive care units [17,18], cancer patients [8,9], or transplant recipients [19].…”

“…Few unselected studies of invasive P. aeruginosa have been conducted. Those studies that have been carried out have been largely descriptive and not compared incident risk factors in P. aeruginosa bacteremic patients relative to the general population [4,[20][21][22].…”

Beatmungsassoziierte Pneumonien

“…Die Initialtherapie der Spätpneumonie sollte in jedem Fall so ausgerichtet sein, dass Staphylococcus aureus und Pseudomonas aeruginosa erfasst werden. Obwohl einige Studien zeigten,dass durch Monotherapie bei Pneumonien insgesamt vergleichbar gute Ergebnisse wie mit Kombinationstherapie erzielt werden können, gibt es klare Hinweise, dass die Kombination für spezielle Erreger wie Pseudomonas aeruginosa überlegen ist [16,67,87].Meist werden Aminoglykoside oder Fluorchinolone mit Betalaktamen kombiniert [125,159]. Von den Aminoglykosiden ist in aller Regel Tobramycin am besten wirksam und von den Fluorchinolonen Ciprofloxacin.Alternativ kommt Levofloxacin in Frage, es wirkt allerdings in vitro etwas schwächer und wird durch weniger klinische Studien als Ciprofloxacin gestützt [125].…”