Korean J Crit Care Med.  2016 Nov;31(4):308-316. 10.4266/kjccm.2015.00703.

High-dose Sulbactam Treatment for Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Acinetobacter Baumannii

• Jeong IB
• Na MJ
• Son JW
• Jo DY
• Kwon SJ

• KMID: 2371186
• DOI: http://doi.org/10.4266/kjccm.2015.00703

Abstract

BACKGROUND
Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP.
METHODS
Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed.
RESULTS
Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality.
CONCLUSIONS
High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.

Keyword

acinetobacter; pneumonia, ventilator-associated; sulbactam

MeSH Terms

Acinetobacter baumannii*
Acinetobacter*
Anti-Bacterial Agents
APACHE
Diagnosis
Humans
Medical Records
Mortality
Pneumonia, Ventilator-Associated*
Sulbactam*
Anti-Bacterial Agents
Sulbactam

Reference

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