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Multidrug-Resistant Pseudomonas aeruginosa in Cystic Fibrosis. Part 2: Management Considerations

Michael D Parkins1,2, Christopher D Sibley1, and J Stuart Elborn3,4

Chronic lower airway infection with Pseudomonas aeruginosa is a hallmark of cystic fibrosis (CF). P aeruginosa is notable for both intrinsic resistance to multiple classes of antibiotics and also a high level of adaptability. P aeruginosa is capable of acquiring a resistant phenotype following antimicrobial exposure by a range of mechanisms [1]. The generally accepted definition of multidrug-resistant (MDR) P aeruginosa is isolates that are resistant to all antibiotics within two or more classes of standard anti-pseudomonal antibiotics [2]. This definition was determined at a consensus conference held in 1994 to deal with the emerging problem of P aeruginosa drug resistance. It has some limitations, particularly in that in vitro resistance is variable within and between sputum samples [3,4].

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