High-dose Sulbactam Treatment for Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Acinetobacter Baumannii.
10.4266/kjccm.2015.00703
- Author:
In Beom JEONG
;
Moon Jun NA
;
Ji Woong SON
;
Do Yeon JO
;
Sun Jung KWON
- Publication Type:Original Article
- Keywords:
acinetobacter;
pneumonia, ventilator-associated;
sulbactam
- MeSH:
Acinetobacter baumannii*;
Acinetobacter*;
Anti-Bacterial Agents;
APACHE;
Diagnosis;
Humans;
Medical Records;
Mortality;
Pneumonia, Ventilator-Associated*;
Sulbactam*
- From:Korean Journal of Critical Care Medicine
2016;31(4):308-316
- CountryRepublic of Korea
- Language:English
-
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.
