[Cefoperazone-sulbactam plus minocycline in the treatment of extensively drug resistant Acinetobacter infections].

Abstract

OBJECTIVE:

To explore the effects of cefoperazone-sulbactam (C/S) plus minocycline on extensively drug resistant Acinetobacter baumannii (XDRAB) infections in critically ill patients.

METHODS:

For this prospective and single-center trial, a total of 101 patients with infection due to XDRAB received the primary therapy of C/S plus minocycline. Combined use of imipenem-cilastatin was considered when primary therapy failed.

RESULTS:

Among them, 77 patients were evaluated. There were 49 males and 28 females with a mean age of (69±20) years. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was 15±5. Among whom 61 had hospital-acquired pneumonia (n=61), primary bacteremia (n=5), intra-abdominal infection (n=3), skin and soft tissue infection (SSTI) (n=2) and multiple sites infection (n=6). Twenty-three patients had mixed bacterial infections. Combined use of imipenem-cilastatin therapy was administered in 7 patients. The treatment duration was (16±4) days. The outcomes were cure (n=21), marked improvement (n=27), improvement (n=26) and ineffectiveness (n=3). The overall effective rate was 62.3% (48/77) and the microbiological clearance rate 46.8% (36/77). The independent factors of decreased efficacy were underlying co-morbidity of impaired ability for infection control (OR=5.3, P=0.020), prolonged infection (OR=3.8, P=0.029), co-infecting organism (OR=3.5, P=0.032) and septic shock (OR=2.5, P=0.037).

CONCLUSIONS:

The combined regimen of C/S and minocycline is efficacious in the treatment of infections caused by XDRAB. But it has a lower rate of microbiological eradication.

• Authors: Yan Shi, Ying-chun Xu, Ye Liu, Wei Du, Xi Rui, Yao Wang
• Journal: Zhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 92 Issue 40 Pg. 2847-50 (Oct 30 2012) ISSN: 0376-2491 [Print] China
• PMID: 23290215 (Publication Type: Journal Article)

Chemical References

• Cefoperazone
• Minocycline
• Sulbactam

Topics

• Acinetobacter Infections (drug therapy, microbiology)
• Acinetobacter baumannii (drug effects)
• Aged
• Aged, 80 and over
• Cefoperazone (administration & dosage, therapeutic use)
• Cross Infection (drug therapy, microbiology)
• Drug Resistance, Bacterial
• Drug Therapy, Combination
• Female
• Humans
• Male
• Middle Aged
• Minocycline (administration & dosage, therapeutic use)
• Prospective Studies
• Sulbactam (administration & dosage, therapeutic use)