Outcome of High Dose Ampicillin-Sulbactam and Colistin Combination Therapy for Treating Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Acinetobacter baumannii: a Pilot Study
- Author:
Seong Hee JEONG
1
;
Young A KIM
;
Go-eun CHOI
;
Su Eun PARK
Author Information
- Publication Type:Original Article
- From:Pediatric Infection & Vaccine 2020;27(1):45-52
- CountryRepublic of Korea
-
Abstract:
Purpose:This pilot study aimed to evaluate the efficacy of high dose ampicillin-sulbactam and colistin combination therapy for ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) in the pediatric intensive care unit of Pusan National University Children's Hospital.
Methods:We retrospectively reviewed 17 pediatric patients with VAP caused by CRAB from June 2017 to August 2018. Ten (58.8%) patients were treated with high dose ampicillin-sulbactam and colistin combination therapy (combination therapy group), whereas 7 were treated with colistin only or with various combinations with or without colistin (other antibiotics group). Clinical and bacteriological outcomes were compared between the groups.
Results:The mean duration of fever after antibiotic use was 1.30±1.70 days in the combination therapy group and 1.71±1.49 days in the other antibiotics group. The mean duration of days for negative conversion of endotracheal aspirate bacterial culture afterantibiotic therapy was 3.40±1.71 days in the combination therapy group and 11.80±8.86 days in the other antibiotics group. The mortality rate within 30 days of antibiotic therapy was 1/10 (10%) in the combination therapy group and 3/7 (42.9%) in the other antibiotics group.
Conclusions:High dose ampicillin-sulbactam and colistin combination therapy as early antibiotic treatment in VAP caused by CRAB in children could improve clinical outcomes.
