How would you manage a patient with necrotizing pneumonia due to a susceptible Pseudomonas aeruginosa strain who continues to have significant purulent secretions and worsening imaging while receiving cefepime?  

I agree, not enough information here to make a firm recommendation, but often times these necrotic pneumonias will undergo significant liquefactive necrosis, and all of that dead lung and purulence has to come out through the mouth. I tell patients that they may have a worse cough for a while, and t...

While we are not told how many days of Cefepime the patient went through, adding a second anti-pseudomonal antibiotic will expand the spectrum against the Pseudomonas spp and increase the chances of healing.

If you have a Pseudomonas region sensitive Cefepime and the patient is not responding, have you done a bronchoscopy to rule out an endobronchial lesion that could be hindering resolution of the pneumonia? If this was done and it was negative, then adding a synergistic agent to set pain would be the ...