Response to: 'Letter to the Editor: 'Management of multidrug-resistant Pseudomonas aeruginosa in the Intensive Care Unit: state of the art''

摘要

We truly thank Dr Plant and colleagues for taking an interest in our review, raising an important issue about the risk of resistance development and clinical failure when ceftolozane/tazobactam (TOL/TAZ) is used against multidrug-resistant (MDR) Pseudomonas aeruginosa (PA) 1,2. TOL/TAZ belongs to the new wave of beta-lactam /beta-lactamase inhibitor combinations and bases its efficacy against Gram-negative bacteria on ceftolozane's higher stability versus AmpC p-lactamase than the predecessor beta-lactam companions of tazobactam 3.The combination with the beta-lactamase inhibitor allows TOL to target many Enterobacteriaceae producing extended-spectrum beta-lactamases 4. Nevertheless, the most intriguing feature of TOL is its potent in vitro activity against PA, not impaired by the most important resistance mechanisms toward beta-lactams such as AmpC-type beta-lactamases, decrement of outer membrane permeability through loss of porins and up-regulation of efflux pumps 5.