Abstract | BACKGROUND: Multidrug-resistant (MDR) Acinetobacter calcoaceticus-Acinetobacter baumannii (Acb) complex has become an important cause of nosocomial pneumonia. Sulbactam is a β-lactamase inhibitor with antimicrobial activity against MDR Acb complex. METHODS: To investigate outcomes of pneumonia involving MDR Acb complex treated with sulbactam or ampicillin/sulbactam for at least 7 days, we conducted a retrospective study of 173 adult patients over a 34 month period. RESULTS: Of 173 patients, 138 (79.8%) received combination therapy, mainly with carbapenems (119/138, 86.2%). The clinical response rate was 67.6% and the 30 day mortality rate was 31.2%. The independent predictors of clinical failure were malignancy, bilateral pneumonia and shorter duration of treatment. In patients with sulbactam-susceptible strains, there was no difference in clinical and microbiological outcome between combination therapy and monotherapy. Compared to the sulbactam-susceptible group, the sulbactam-resistant group had a lower rate of airway eradication, a longer duration of treatment and a higher rate of combination therapy with predominantly carbapenems (p < 0.05). There was no significant difference between the two groups in clinical resolution and 30 day mortality rates. CONCLUSIONS:
|
Authors | Huang-Shen Lin, Ming-Hsun Lee, Chun-Wen Cheng, Po-Chang Hsu, Hsieh-Shong Leu, Ching-Tai Huang, Jung-Jr Ye |
Journal | Infectious diseases (London, England)
(Infect Dis (Lond))
Vol. 47
Issue 6
Pg. 370-8
(Jun 2015)
ISSN: 2374-4243 [Electronic] England |
PMID | 25746600
(Publication Type: Comparative Study, Journal Article, Observational Study)
|
Chemical References |
- Anti-Bacterial Agents
- Carbapenems
- sultamicillin
- Ampicillin
- Sulbactam
|
Topics |
- Acinetobacter Infections
- Acinetobacter baumannii
(drug effects, isolation & purification)
- Acinetobacter calcoaceticus
(drug effects, isolation & purification)
- Adult
- Aged
- Ampicillin
(administration & dosage, therapeutic use)
- Anti-Bacterial Agents
(therapeutic use)
- Carbapenems
(therapeutic use)
- Drug Resistance, Multiple, Bacterial
- Drug Therapy, Combination
- Female
- Humans
- Male
- Microbial Sensitivity Tests
- Middle Aged
- Pneumonia, Bacterial
(drug therapy, microbiology)
- Retrospective Studies
- Sulbactam
(administration & dosage, therapeutic use)
- Taiwan
- Time Factors
|