What is the first-line treatment for Pseudomonas aeruginosa infections?

The choice of piperacillin-tazobactam or ceftazidime as the first-line treatment for Pseudomonas aeruginosa infections is based on their effectiveness against this specific pathogen, which is known for its resistance features and clinical significance in various infections, particularly in immunocompromised patients.

Piperacillin-tazobactam is a broad-spectrum penicillin antibiotic combined with a beta-lactamase inhibitor, enhancing its efficacy against beta-lactamase producing organisms, including Pseudomonas. Ceftazidime is a third-generation cephalosporin that demonstrates strong activity against Pseudomonas aeruginosa as well. Both of these agents can achieve effective concentrations in tissues and are often utilized in empiric therapy for serious infections such as pneumonia, bloodstream infections, and urinary tract infections caused by this organism.

In contrast, while ciprofloxacin is a fluoroquinolone with activity against Pseudomonas, it is typically not the first-line treatment for severe infections due to concerns about resistance and its pharmacokinetic profile in critical cases. Vancomycin is primarily effective against Gram-positive bacteria, particularly staphylococci, and is not effective against Pseudomonas.