Infectious Diseases in Critical Care Medicine

not be treated/covered and is difficult to eradicate. Because colonization is difficult to
eradicate, antibiotic therapy of colonization predisposes to the development of MDR
P. aeruginosa, K. pneumoniae,orA. baumannii
Infections due to MDR GNBs are treated with antibiotics to which the MDR strain is
susceptible. Therapy of MDR GNBs may be via the oral route for noncritical infections, i.e.,
CAB or via the IV route for serious systemic infections in critically ill patients (Tables 1 and 2)
(6,10).

REFERENCES

1. Cunha BA. Antibiotic resistance: control strategies. Critical Care Clinics 1998; 8:309–328.


2. Cunha BA. Effective antibiotic resistance and control strategies. Lancet 2001; 357:1307–1308.


3. Cunha BA. The significance of antibiotic false sensitivity testing within vitrotesting. J Chemother
   1997; 9:25–35.


4. Ristuccia PA, Jonas M, Cunha BA. Antibiotic susceptibility of ampicillin-resistantE. coliin urine to
   antibiotics at urinary concentration. Adv Ther 1986; 3:163–167.


5. Hamid NS, Cunha BA, Klein NC. Falsely high antibiotic resistance in hospitalized patients withE. coli
   urinary tract infections. Mayo Clin Proc 2005; 80:824–825.


6. Cunha BA, ed. Antibiotic Essentials. 8th ed. Sodbury, MA: Jones & Bartlett; 2009.


7. Cunha BA, ed. Pneumonia Essenitials. 3rd ed. Sodbury, MA: Jones & Bartlett; 2009.


8. Cunha BA. Ventilator associated pneumonia: monotherapy is optimal if chosen wisely. Crit Care Med
   2006; 10:e141–e142.


9. Cunha BA.Pseudomonas aeruginosa: antibiotic resistance and antimicrobial therapy. Sem Resp Ther
   2002; 17:231–239.


10. Cunha BA. Multidrug resistant (MDR) Klebsiella, Acinetobacter, andPseudomonas aeruginosa. Antibiot
    Clin 2006; 10:354–355.


11. Cunha BA. SeriousPseudomonas aeruginosainfections in hospitalized patients. Antibiot Clin 2003; 7
    (S2):31–38.


12. Aloush V, Navon-Venezia S, Seigman-Igra Y, et al. Multidrug-resistantPseudomonas aeruginosa: risk
    factors and clinical impact. Antimicrob Agents Chemother 2006; 50:43–48.


13. Mastoraki A, Douka E, Kriaras I, et al.Pseudomonas aeruginosasusceptible only to colistin in intensive
    care unit patients. Surg Infect 2008; 9:153–160.


14. Koomanachai P, Tiengrim S, Kiratisin P, et al. Efficacy and safety of colistin (colistimethate sodium)
    for therapy of infections caused by multidrug-resistantPseudomonas aeruginosaandAcinetobacter
    baumanniiin Siriraj Hospital, Bangkok, Thailand. Int J Infect Dis 2007; 11:402–406.


15. Furtado GH, d’Azevedo PA, Santos AF, et al. Intravenous polymyxin B for the treatment of
    nosocomial pneumonia caused by multidrug-resistantPseudomonas aeruginosa. Int J Antimicrob
    Agents 2007; 30:315–319.


16. Chiang T, Mariano N, Urban C, et al. Identification of carbapenem-resistantKlebsiella pneumoniae
    harboring KPC enzymes in New Jersey. Microb Drug Resist 2007; 13:235–239.


17. Antoniadou A, Kontopidou F, Poulako G, et al. Colistin-resistant isolates ofKlebsiella pneumoniae
    emerging in intensive care unit patients: first report of a multiclonal cluster. J Antimicrob Chemother
    2007; 59:786–790.


18. Parchuri S, Mohan S, Young S, et al.. Extended spectrum beta-lactamase-producingKlebsiella
    pneumoniaechronic ambulatory peritoneal dialysis peritonitis treated successfully with Polymyxyin B.
    Heart Lung 2005; 34: 360–363.


19. Cunha BA, McDermott B, Nausheen S. A single once daily high dose therapy of tigecycline of a
    multidrug resistant (MDR)Klebsiella pneumoniaeandEnterobacter agglomeransnosocomial urinary tract
    infection. J Chemother 2008; 19:753–754.


20. Cunha BA. Pharmokinetic considerations regarding tigecycline for multidrug-resistant (MDR)klebsiella
    pneumoniaeor MDRAcinetobacter baumanniiurosepsis. J Clin Microbiol 2009; 47:1613.


21. Marchaim D, Navon-Venezia S, Schwartz D, et al. Surveillance cultures and duration of carriage of
    multidrug-resistantAcinetobacter baumannii. J Clin Microbiol 2007; 45:1551–1555.


22. Stephens C, Francis SJ, Abell V, et al. Emergence of resistantAcinetobacter baumanniiin critically ill
    patients within an acute care teaching hospital and long-term acute care hospital. Am J Infect Control
    2007; 35:212–215.


23. Lee NY, Lee HC, Ko NY, et al. Clinical and economic impact of multidrug resistance in nosocomial
    Acinetobacter baumanniibacteremia. Infect Control Hospt Epidemiol 2007; 28:713–719.


24. Abbo A, Carmeli Y, Navon-Venezia S, et al. Impact of multi-drug-resistantAcinetobacter baumanniion
    clinical outcomes. Eur J Clin Microbiol Infect Dis 2007; 26:793–800.

Antibiotic Therapy of MDRP. aeruginosa, K. pneumoniae, andA. baumanniiin CCU 519