If the infection site of penicillin is limited on the outside, it can be effectively washed with 1% acetic acid or locally coated with polymyxin B or polymyxin E. The necrotic tissue must be enlarged and the abscess must be drained. If parenteral administration is needed, most urinary tract infections caused by Pseudomonas aeruginosa can be cured by giving 5 mg/(kg d) tobramycin or gentamicin. According to the clinical response, the dosage can be reduced to 3 mg/(kg d) to minimize the side effects. People with renal insufficiency must reduce the dose. Amikacin was applied to Pseudomonas aeruginosa with enzyme-mediated resistance to tobramycin and gentamicin. Many experts advocate that aminoglycosides plus anti-Pseudomonas β -lactams can be used to treat serious Pseudomonas infection. Several penicillins, including ticarcillin, piperacillin, mezlocillin and azlocillin, are also effective against Pseudomonas aeruginosa. Other effective drugs include ceftazidime, cefapine, aztreonam, imipenem, meropine and ciprofloxacin. Ticarcillin is most commonly used, and the dosage is 16~20g/d, and it is injected intravenously. Piperacillin, azlocillin, cefapine, ceftazidime, meropinene and imipenem are effective against some drug-resistant strains in ticarcillin in vitro.
For patients with systemic infection or agranulocytosis, aminoglycoside anti-Pseudomonas aeruginosa drugs and anti-Pseudomonas aeruginosa penicillin should be used in combination. For patients with neutropenia and marginal renal function, non-aminoglycoside combination therapy, such as bis-β-lactams or β -lactams plus fluoroquinolones, is also safe. Urinary tract infection can usually be treated with Kabunda benzylpenicillin or ciprofloxacin or other fluoroquinolones. However, fluoroquinolones should not be used in children because of their adverse effects on cartilage. When the two anti-Pseudomonas drugs are used in combination, the chances of drug-resistant strains appearing during treatment are obviously reduced.