Study on the influential factors for clinical efficacy of polymyxin B combined with other antibiotics in the treatment of carbapenem-resistant Acinetobacter baumannii pulmonary infection
10.6039/j.issn.1001-0408.2025.12.13
- VernacularTitle:多黏菌素B联合其他抗菌药物治疗CRAB肺部感染临床效果的影响因素研究
- Author:
Mei DU
1
;
Ruijuan TAN
;
Lidan WANG
;
Hejun CHEN
;
Hanze LI
;
Yuanyuan ZHANG
Author Information
1. 衡水市人民医院药学部,河北 衡水 053000
- Publication Type:Journal Article
- Keywords:
polymyxin B;
antibiotics;
carbapenem-resistant Acinetobacter baumannii;
pulmonary infection;
clinical efficacy;
influential factors
- From:
China Pharmacy
2025;36(12):1495-1499
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze the influential factors for clinical efficacy of polymyxin B combined with other antibiotics in the treatment of carbapenem-resistant Acinetobacter baumannii(CRAB)pulmonary infection.METHODS A retrospective analysis was conducted on the clinical data of patients with CRAB pulmonary infection in our hospital from May 2021 to October 2024.Information such as age,gender,admitting department,infection status,underlying medical conditions,mechanical ventilation time,combination anti-infective treatment regimens,and the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE-Ⅱ)score 24 h before medication was compiled.Based on the effectiveness of the treatment,patients were divided into treatment-effective group and treatment-ineffective group.Univariate analysis and multivariate Logistic regression analysis were employed to identify independent factors influencing clinical efficacy.RESULTS A total of 156 patients were included,and 108 patients were treated effectively,with an effective rate of 69.23%.The results of univariate analysis indicated that there were statistically significant differences between 2 groups in terms of the duration of mechanical ventilation time,APACHE-Ⅱ score 24 h before medication,the number of complication types,the proportion of abnormal coagulation function,anti-infective treatment course,and hospital stay before medication(P＜0.05).The results of multivariate Logistic regression analysis showed that APACHE-Ⅱ score≥15 points 24 h before medication[OR=2.965,95%CI(1.284,6.845),P=0.020],mechanical ventilation time≥10 d[OR=3.577,95%CI(1.185,10.793),P=0.037]and hospital stay≥14 d before medication[OR=2.422,95%CI(1.036,5.654),P=0.041]were independent risk factors,and anti-infective treatment course＞7 d was a protective factor[OR=0.445,95%CI(0.221,0.895),P=0.043].CONCLUSIONS This study shows that the effective rate of polymyxin B combined with other antibiotics in the treatment of CRAB pulmonary infection is less than 70%.The mechanical ventilation time≥10 d,APACHE-Ⅱ score≥15 points 24 h before medication,and hospital stay≥14 d before medication may lead to treatment failure,whereas anti-infective treatment course＞7 d may be associated with treatment success.
