[Efficacy of extended-infusion of carbapenem plus sulbactam for ventilator-associated pneumonia caused by extensive drug-resistant Acinetobacter baumannii].

Abstract

Objective: To evaluate the efficacy of extended-infusion of carbapenem plus sulbactam for ventilator-associated pneumonia caused by extensive drug-resistant Acinetobacter baumannii (XDRAB). Methods: Clinical data of patients with ventilator-associated pneumonia caused by XDRAB who were treated with extended-infusion carbapenem plus sulbactam or tigecycline-based therapy in Peking University First Hospital from January 2015 to December 2016 were collected and reviewed in this retrospective study. Twenty-one patients were treated with extended-infusion carbapenem plus sulbactam, and 20 other patients received tigecycline combined with other antibiotics. The general status of the patient, microbiological eradication rate, superinfection rate, new microorganism colonization rate, clinical resolution rate on the third day, clinical cure rate and mortality during treatment were compared between the two groups. Results: The two groups shared similar characteristics except that patients in the carbapenem group were younger. Microbiological eradication was not observed. Superinfections occurred in 1 patients (4.8%) in the carbapenem group and 0 patients in the tigecycline group (P=1.000), the occurrences of new microorganisms colonization were 14.3% and 25.0% respectively (P=0.638). Clinical cure were achieved in 57.1% of the patients in the carbapenem group and 50.0% of the patients in the tigecycline group (P=0.647), the clinical resolution rates on the third day were 52.4% and 45.0% respectively (P=0.636). The mortality during treatment was 9.5% in carbapenem group, and 20.0% in tigecycline group (P=0.612). No serious adverse drug reactions occurred. Conclusions: Ventilator-associated pneumonia caused by XDRAB treated with either extended-infusion carbapenem plus sulbactam or tigecycline-based therapy has a similar clinical outcome.

• Authors: X Wang, Y Hu, C L Que, H Zhang, J J Huang, J Cao, Z Jin, G F Wang, W Zhang
• Journal: Zhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 97 Issue 38 Pg. 2996-3000 (Oct 17 2017) ISSN: 0376-2491 [Print] China
• PMID: 29061006 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Carbapenems
• Sulbactam
• Colistin

Topics

• Acinetobacter Infections (drug therapy)
• Acinetobacter baumannii
• Anti-Bacterial Agents (therapeutic use)
• Carbapenems (therapeutic use)
• Colistin
• Drug Resistance, Multiple, Bacterial
• Humans
• Pneumonia, Ventilator-Associated (drug therapy)
• Retrospective Studies
• Sulbactam (therapeutic use)