Pseudomonas aeruginosa en la otitis externa canina: situación actual
DOI:
https://doi.org/10.24215/15142590e048Palabras clave:
otitis externa, Pseudomonas aeruginosa, antimicrobianos, PK/PD, caninosResumen
La otitis externa es una enfermedad de presentación frecuente en la práctica diaria. La comprensión de su fisiopatología es importante para su prevención, diagnóstico y tratamiento. El protocolo diagnóstico debe ser estricto, siendo fundamental el rol que cumplen en estos casos el cultivo bacteriano y el antibiograma. Pseudomonas aeruginosaes un microorganismo oportunista e invasor, que constituye en sí mismo un factor perpetuante para las otitis crónicas. Además de sus factores de virulencia y la resistencia intrínseca a múltiples fármacos, forma biopelículas de protección sobre tejidos colonizados y posee gran capacidad para adquirir genes determinantes de resistencia cromosómica y extra cromosómica durante el tratamiento. Los casos crónicos o recurrentes con aislamientos de P. aeruginosa resultan un desafío constante para el veterinario. El oído externo tiene escasa irrigación, por lo cual los antimicrobianos sistémicos no alcanzan concentraciones adecuadas, siendo la terapia tópica la primera elección. El éxito terapéutico evoluciona hacia la aplicación de pautas farmacocinéticas/farmacodinámicas, desde una concepción netamente empírica hasta una concepción cuantitativa, permitiendo describir y simular el efecto de un antibiótico sobre una población bacteriana en función del tiempo, mediante la modelización matemática de los datos experimentales, con objeto de maximizar la eficacia y minimizar fenómenos de resistencia.
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