High-dose ampicillin-sulbactam as an alternative treatment of late-onset VAP from multidrug-resistant Acinetobacter baumannii
High-dose ampicillin-sulbactam as an alternative treatment of late-onset VAP from multidrug-resistant Acinetobacter baumannii
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DOI：
10.1080/00365540600951184
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发表时间：
2007-01-01
影响因子：
--
通讯作者：
Georgiadis, George
中科院分区：
文献类型：
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作者：
Betrosian, Alex P.;Frantzeskaki, Frantzeska;Georgiadis, George
重症患者中多重耐药（MDR）鲍曼不动杆菌呼吸机相关性肺炎的发生率增加，给治疗带来了严重问题。本研究的目的是评价2种大剂量氨苄西林-舒巴坦（A/S）治疗多药耐药鲍曼不动杆菌VAR的有效性和安全性。我们对（MDR）鲍曼不动杆菌VAR危重患者进行了一项随机、前瞻性试验。（以2：1的速率每8小时一次）：1）A组，18/9 g日剂量（n = 14）;和2）B组，24/12 g日剂量（n = 13）。两组的治疗持续时间均为8 ± 2 d。共有27例患者入组本研究。A组和B组分别有9/14（64.3%）和9/13（69.2%）例患者的66.7%的研究人群出现临床改善。77.8%的研究人群（12/14，A组85.7%）和9/13（69.2%）的B组患者实现了细菌学成功。14 d死亡率为25.9%，30 d全因死亡率为48.1%。两组的死亡率无显著差异。无严重不良反应记录。我们的结论是，该研究的临床和细菌学结果支持使用大剂量氨比西林-舒巴坦方案治疗耐药鲍曼不动杆菌VAP。
The increased incidence of multidrug-resistant (MDR) Acinetobacter baumannii ventilator-associated pneumonia in critically ill patients poses a severe therapeutic problem. The aim of this study was to evaluate the efficacy and safety of 2 high-dose treatment regimens of ampicillin-sulbactam (A/S) for MDR Acinetobacter baumannii VAR We undertook a randomized, prospective trial of critically ill patents with (MDR) Acinetobacter baumannii VAR Patients were randomly assigned to I of 2 treatment regimens of A/S (at a rate 2:1 every 8 h): 1) group A, 18/9 g daily dose (n = 14); and 2) group B, 24/12 g daily dose (n = 13). The duration of therapy was 8 +/- 2 d for both groups. A total of 27 patients were enrolled in the study. Clinical improvement was seen in 66.7% of the study population in 9/14 (64.3%) of group A patients and 9/13 (69.2%) of group B patients, respectively. Bacteriological success was achieved in 77.8% of the study population (12/14, 85.7% of group A) and in 9/13 (69.2%) of group B patients. The 14-d mortality rate was 25.9% and the all cause 30-d mortality was 48.1%. Both mortality rates did not differ significantly between the 2 groups. No major adverse reactions were recorded. We concluded that clinical and bacteriological results of the study support the use of high-dose regimen of ampicillin-sulbactam for MDR Acinetobacter baumannii VAP.