Comparing Antipseudomonal Antibiotics for Managing Pseudomonas aeruginosa Bacteremia in the ICU

Use of newer antipseudomonal cephalosporins was associated with lower mortality in high-risk patients with Pseudomonas aeruginosa bacteremia.

Pseudomonas aeruginosa is a common component of bloodstream infections (BSIs) in the ICU. Although clinicians have several antibiotic options, comparisons of their effects on outcomes are lacking. Bavaro et al. performed a retrospective observational study of 170 patients with P. aeruginosa BSIs at 14 Italian hospitals; all patients received antimicrobial therapy for >48 hours. The investigators evaluated predictors of 30-day mortality, including the definitive antimicrobial therapy that was selected.

About one third of the patients had septic shock, and 23% had carbapenem-resistant infections. Antipseudomonal therapy consisted of piperacillin/tazobactam (22%), carbapenems (43%), colistin (7%), or newer cephalosporins comprising ceftolozane/…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases