Hospital-acquired infections are one of the most important challenges to patient safety, especially in critical care units. The use of broad-spectrum antibiotics results frequently in multidrug-resistant pathogens. Therefore, we are attending to increased rates of multidrug-resistant microorganisms, especially gram-negative bacilli, that have been associated with prolonged hospital stays, higher costs, and increased mortality. The most important multidrug-resistant pathogens are PSEUDOMONAS AERUGINOSA and ACINETOBACTER BAUMANNII. There has been an important but as yet unsuccessful effort to develop new drugs to treat these pathogens. Nevertheless, old, very well known drugs, such as polymyxins, administered intravenously and aerosolized, have been revisited. Future options include immunotherapy or the continuous infusion of antibiotics. It is also important to emphasize the rational use of antibiotics to diminish the appearance of multiresistant pathogens.
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