Table 2
Antibiotics used against Pseudomonas aeruginosa
| Category | Examples | Comment |
|---|---|---|
| Carboxypenicillins | Ticarcillin | Greater antipseudomonas activity and less sodium load than carbenicillin |
| Temocillin | 6α-methoxy substitution gives long half life and more resistance against β-lactamase enzymes | |
| Ureido and piperazine penicillins | Azlocillin | Acyl derivative of urea as side chain |
| Piperacillin | Piperazine side chain; not used in cystic fibrosis because of adverse reactions | |
| Cephalosporin | Ceftazidime | Third generation |
| Aminoglycosides | Gentamicin, tobramycin, amikacin | Toxicity of aminoglycosides is based on accumulation, major side effects are on ear and kidney. Measure serum trough and peak levels at third dose, and regularly afterwards |
| Quinolone | Ciprofloxacin | Only oral antipseudomonal antibiotic |
| Monobactam | Aztreonam | Narrow spectrum of action; Gram-positive superinfection may be a problem if used alone |
| Carbapenem | Meropenem, imipenem | Members of a new class of β-lactam called the thienamycins; imipenem has to be combined with inhibitor cilastatin to block renal metabolism, but meropenem is stable to the renal enzyme |
| Beta lactamase inhibitor | Tazocin | Piperacillin and tazobactam |
| Polymyxin | Colomycin | Usually given by inhalation because of possible side effects when given parenterally |
-
Compiled from references 2 and 7.
