Friday, September 01, 2006

Double coverage and pseudomonas, part I

Enough of this fluff, it’s time for a little meat. Here’s a clinical problem I experienced as an intern last year: the pharmacist called because my patient with a leg ulcer was growing out pseudomonas, and she was concerned that the patient was only on single coverage with zosyn.
“The pseudomonas is sensitive to zosyn, though, right?” I asked.
“Yes,” she confirmed.
“So why would we want to double cover?”
“Well, usually it’s recommended to double cover against pseudomonas so it won’t develop resistance.”
“Hmm, I’m not sure that makes sense to me – I thought we only double covered empirically until we found out the sensitivities – let me talk with my team and get back to you.”

So who was right? Discussion to follow. . .