{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T11:26:39Z","timestamp":1769599599700,"version":"3.49.0"},"reference-count":71,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:00:00Z","timestamp":1645142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>The rise in multiple-drug-resistant (MDR) phenotypes in Gram-negative pathogens is a major public health crisis. Pseudomonas aeruginosa is one of the leading causes of nosocomial infections in clinics. Treatment options for P. aeruginosa have become increasingly difficult due tdo its remarkable capacity to resist multiple antibiotics. The presence of intrinsic resistance factors and the ability to quickly adapt to antibiotic monotherapy warrant us to look for alternative strategies like combinatorial antibiotic therapy. Here, we report the frequency of P. aeruginosa multidrug-resistant and extensively drug-resistance (XDR) phenotypes in a super-specialty tertiary care hospital in north India. Approximately 60 percent of all isolated P. aeruginosa strains displayed the MDR phenotype. We found highest antibiotic resistance frequency in the emergency department (EMR), as 20 percent of isolates were resistant to 15 antipseudomonal antibiotics. Presence of plasmids with quinolone-resistance determinants were major drivers for resistance against fluoroquinolone. Additionally, we explored the possible combinatorial therapeutic options with four antipseudomonal antibiotics\u2014colistin, ciprofloxacin, tobramycin, and meropenem. We uncovered an association between different antibiotic interactions. Our data show that the combination of colistin and ciprofloxacin could be an effective combinatorial regimen to treat infections caused by MDR and XDR P. aeruginosa.<\/jats:p>","DOI":"10.3390\/ph15020243","type":"journal-article","created":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T08:23:29Z","timestamp":1645431809000},"page":"243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Potential Synergistic Antibiotic Combinations against Fluoroquinolone-Resistant Pseudomonas aeruginosa"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8764-8533","authenticated-orcid":false,"given":"Ashish","family":"Kothari","sequence":"first","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences Rishikesh, Rishikesh 249203, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3736-8621","authenticated-orcid":false,"given":"Neeraj","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences Rishikesh, Rishikesh 249203, India"},{"name":"Division of Cancer Biology, Central Drug Research Institute, Lucknow 226031, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyam","family":"Kishor Kumar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences Deoghar, Deoghar 814152, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankur","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences Rishikesh, Rishikesh 249203, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karanvir","family":"Kaushal","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, All India Institute of Medical Sciences Rishikesh, Rishikesh 249203, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satinder","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6954-6990","authenticated-orcid":false,"given":"Atul","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Ecology, Evolution and Behavior, The Hebrew University of Jerusalem, Jerusalem 9190401, Israel"},{"name":"Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4657-394X","authenticated-orcid":false,"given":"Amit","family":"Gaurav","sequence":"additional","affiliation":[{"name":"Satbiome, Dehradun 248007, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7805-2730","authenticated-orcid":false,"given":"Balram Ji","family":"Omar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences Rishikesh, Rishikesh 249203, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.cell.2020.02.056","article-title":"The Science of Antibiotic Discovery","volume":"181","author":"Lewis","year":"2020","journal-title":"Cell"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.mib.2019.10.008","article-title":"Antibiotics: Past, present and future","volume":"51","author":"Hutchings","year":"2019","journal-title":"Curr. 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