Pseudomonas aeruginosa infection treatment

Hodson, M.E., Penketh, A.R. and Batten, J.C. (1981). Aerosol carbenicillin and gentamicin treatment of Pseudomonas aeruginosa infection I patients with cystic fibrosis. Lancet 2 1137-1139. 

Mpller NE, Hpiby N. Antibiotic treatment of chronic Pseudomonas aeruginosa infection in cystic fibrosis patients. Scand J Infect Dis 1981 24(suppl) 87-91. 

Studies by Desmard and co-workers have shown that CO-RM-3 is a potential treatment for Pseudomonas aeruginosa infection. Infected mice treated with CO-RM-3 show increased survival rates. Clark and coworkers have shown that administration of CO-RM-3 to mice that have had a heart transplant enables them to survive longer than ones that receive no CO-RM-3. In addition to this, i-CO-RM-3 is a solution of CO-RM-3 that has been allowed to release one CO thermally and this solution shows no improvement compared to the control, suggesting the effect is due to the action of CO. There are however some problems with i-CO-RM-3. Only one CO from CO-RM-3 is released thermally and the exact... 

Montero M, Horcajada JP, Sorlf L, Alva-rez-Lerma F, Grau S, Riu M, Sala M, Knobel H. Effectiveness and safety of colistin for the treatment of multidrug-resistant Pseudomonas aeruginosa infections. Infection 2009 37(5) 461-5. 

Pires, D.P., Vilas Boas, D., SiUankorva, S., Azeredo, J., 2015. Phage therapy a step forward in the treatment of Pseudomonas aeruginosa infections. J. Virol. 89, 7449-7456. 

Pefloxacin (33) is the N-methyl analogue of norfloxacin (58) and is at least partly converted to it by metabolic enzymes in vivo. It has been launched in France for the treatment of a number of infections including those caused by sensitive strains of Pseudomonas aeruginosa. It can be synthesized starting with the Gould-Jacobs reaction of 3-chloro-4-fluoroaniline (28) and diethyl ethoxymethylenemalonate in an addition-elimination sequence leading to 29 which undergoes... 

These agents generally have been replaced by more agents due to resistance. This combination is highly effective against most aerobic enteric bacteria except Pseudomonas aeruginosa. High urinary tract tissue levels and urine levels are achieved, which may be important in complicated infection treatment. Also effective as prophylaxis for recurrent infections,... 

Newer examples of aminoglycoside antibiotics include amikacin, neomycin (Neosporin, Cortisporin), and tobramycin (TOBI, TobraDex). Injectable tobramycin is used in the treatment of serious infections at many body sites. It has also been formulated in an inhalable dosage form that has a very specific use to treat cystic fibrosis patients having Pseudomonas aeruginosa lung infections. In the form suitable for inhalation by the patient, it delivers the antibiotic directly to the site of infection. 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

The fluoroquinolones represent an important therapeutic advance and are extremely useful agents. They are important for the treatment of Gram-negative urinary tract infections, especially those from sulfa-resistant strains of E. coli, and for the treatment of serious hacterial infections such as those caused by Pseudomonas aeruginosa. On the basis of microbiological considerations, the fluoroquinolones may be further subdivided into three groups ... 

Obritsch MD, Fish DN, MacLaren R, Jung R. Nosocomial infections due to multidrag-resistant Pseudomonas aeruginosa epidemiology and treatment options. Pharmacotherapy. 2005 25 1353-1364. 

The breakthrough in the development of quinolones came with the appearance of norfloxacin 6 [19], a second-generation quinolone which combined a 6-fluorine substituent with a piperazine ring in the 7-position of the basic compound. Additional quinolones then followed in rapid succession pefloxacin [20], enoxacin [21] and fleroxacin [22] (Fig. 14.5). Particular mention must be made of ciprofloxacin 8 [23-25], ofloxacin 5 [26,27] and its active enantiomer levofloxacin 7 [28]. These quinolones have a broad spectrum of activity, which also includes Gram-positive bacteria and Pseudomonas aeruginosa, as well as favorable pharmacokinetics. The rapid absorption of these compounds from the gastrointestinal tract and their effective tissue penetration also allows them to be used for the treatment of systemic infections. 

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