**15.** *P. aeruginosa* **and mechanisms of resistance**

The mechanisms of resistance in *P. aeruginosa* against antibiotics can be intrinsic, adaptive, or acquired. Innately *P. aeruginosa* is resistant to many antibiotics. Intrinsically it has impermeable cell wall, outer membrane protein (Opr) channels, and multi-drug efflux pumps which give the bacteria resistance to certain antibiotics. Extended treatment and continuous use of higher therapeutic doses resulting in complete resistance [65].
