[Antipyocyanic antibiotic therapy. Principles and efficacy factors]

Pseudomonas aeruginosa is among the bacterial species one of the most resistant "naturally" to antibiotics and one of which acquires most easily resistance to antibiotics. The major principle of the treatment of the infections due to P. aeruginosa is the use of antibiotic association to decrease the risk of emergence of resistant strains. Pharmacokinetic-pharmacodynamic parameters of antimicrobials with antipseudomonal activity are gaining importance as a mean of optimization of antibiotic therapy: tobramycin among the aminosides, ceftazidime among the beta-lactam antibiotics and ciprofloxacin among the quinolones have the best profile. The new mechanisms of pathogenicity or resistance (biofilm secretion, quorum sensing, hypermutator phenomenon) far from being opposed to the rules of prescription reinforce and complicate them.