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[Monotherapy of Pseudomonas aeruginosa septicemia with azlocillin]
Abstract:
Azlocillin was administered alone to seven patients without malignant or blood disease presenting with septicaemia caused by Pseudomonas aeruginosa. In 6 cases the infection developed after surgery and in 3 of these it was responsible for a state of shock, twice associated with acute anuric renal failure. The minimum inhibitory concentrations of azlocillin varied from 2 to 32 micrograms/ml; 5 strains were resistant to carbenicillin. The minimum inhibitory to minimum bactericidal concentrations ratio, measured on five occasions, was equal to 2. Bacterial eradication was obtained in 6 patients. One patient with multivisceral failure died during treatment and in this case the responsible organism had become resistant to azlocillin.
Insights
Azlocillin effectively treated Pseudomonas aeruginosa sepsis in most surgical patients. However, one patient developed resistance and died from multivisceral failure, highlighting treatment challenges.
Area of Science:
- Pharmacology
- Infectious Diseases
- Critical Care Medicine
Background:
- Pseudomonas aeruginosa is a significant cause of post-surgical infections, often leading to severe complications like shock and renal failure.
- Antibiotic resistance, particularly to carbenicillin, is a growing concern in managing P. aeruginosa infections.
Observation:
- Seven patients with P. aeruginosa septicaemia, primarily post-surgery, were treated with azlocillin.
- Three patients experienced shock, with two cases complicated by acute anuric renal failure.
- Azlocillin minimum inhibitory concentrations ranged from 2 to 32 µg/ml; five strains showed carbenicillin resistance.
Findings:
- Bacterial eradication was achieved in six out of seven patients treated with azlocillin.
- The minimum inhibitory to minimum bactericidal concentration ratio for azlocillin was consistently 2.
- One patient with multivisceral failure succumbed to the infection after the organism developed azlocillin resistance.
Implications:
- Azlocillin demonstrates significant efficacy in treating P. aeruginosa septicaemia, especially in post-surgical settings.
- The emergence of azlocillin resistance in a critical case underscores the need for vigilant monitoring and alternative therapeutic strategies.
- This study highlights the importance of considering antibiotic resistance patterns in Pseudomonas aeruginosa infections and tailoring treatment accordingly.