Challenges and Strategies in Managing β-Lactam–Resistant Pseudomonas aeruginosa in China

Abstract β-Lactam antibiotics are the cornerstone of therapy for Pseudomonas aeruginosa infections. Their effectiveness, however, has been increasingly compromised by antimicrobial resistance. This article presents a perspective on the evolving challenges and strategies associated with β-lactam resistance in P. aeruginosa, with a particular focus on China. The perspective was developed through a focused narrative review of recent clinical, epidemiological, and mechanistic studies. We first outline the current epidemiology of β-lactam–resistant P. aeruginosa, highlighting regional trends and the dissemination of high-risk clones. We then review the evolving β-lactam resistance mechanisms, emphasizing the prevalence and variety of carbapenemases. Finally, we discuss therapeutic strategies for managing resistant infections. This includes diagnostic advances, rational selection of novel β-lactam agents, dosing optimization, and combination regimens. Together, these insights provide a structured framework for understanding and managing β-lactam–resistant P. aeruginosa in contemporary clinical practice.