Antimicrobial Agents and Chemotherapy

Rodríguez-Rojas A, Couce A & Blázquez J.

Chronic infections caused by Pseudomonas aeruginosa are probably the most recurrent clinical situation where antibiotic treatment fails. The presence of hypermutable strains exacerbates this phenomenon and appears to be an important factor for the development of multiple-antimicrobial resistance. The shortage of new antimicrobials led to reconsider old antibiotics, including fosfomycin, as appealing alternatives for treatments. Good effectiveness of fosfomycin combined with other antibiotics has been reported. However, P. aeruginosa has a very high mutant frequency to fosfomycin resistance in vitro and in vivo, suggesting an elevated risk of resistance to combined treatments.