| Efficacy and safety of high-dose ampicillin/sulbactam vs. colistin as monotherapy for the treatment of multidrug resistant Acinetobacter baumannii ventilator-associated pneumonia. | |
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MedLine Citation:
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PMID: 18501431 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare the safety and efficacy of ampicillin/sulbactam (Amp/Sulb) and colistin (COL) in the treatment of multidrug resistant Acinetobacter baumannii ventilator-associated pneumonia (VAP). METHODS: A prospective cohort study in adult critically ill patients with VAP. Patients were randomly assigned to receive Amp/Sulb (9 g every 8h) or COL (3 MIU every 8h) intravenously. Dosage was adjusted according to creatinine clearance. RESULTS: A total of 28 patients were enrolled (15 COL, 13 Amp/Sulb). Resolution of symptoms and signs occurred in 60% (9/15) of the COL group and 61.5% (9/13) of the Amp/Sulb group, improvement in 13.3% (2/15) vs. 15.3% (1/13) and failure in 26.6% (4/15) vs. 23% (3/13), respectively. The difference was not statistically significant. Bacteriologic success was achieved in 66.6% (10/15) vs. 61.5% (8/13) in the COL and Amp/Sulb groups, respectively (p<0.2). Mortality rates (14 days and 28 days) were 15.3% and 30% for the Amp/Sulb and 20% and 33% for the COL group, respectively. Adverse events were 39.6% (including 33% nephrotoxicity) for the COL group and 30.7% (15.3% nephrotoxicity) for the Amp/Sulb group (p=NS). CONCLUSION: Colistin and high-dose ampicillin/sulbactam were comparably safe and effective treatments for critically ill patients with MDR A. baumannii VAP. |
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Authors:
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Alex P Betrosian; Frantzeska Frantzeskaki; Anna Xanthaki; Emmanuel E Douzinas |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2008-05-23 |
Journal Detail:
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Title: The Journal of infection Volume: 56 ISSN: 1532-2742 ISO Abbreviation: J. Infect. Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-09 Completed Date: 2008-07-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7908424 Medline TA: J Infect Country: England |
Other Details:
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Languages: eng Pagination: 432-6 Citation Subset: IM |
Affiliation:
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3rd Department of Critical Care, Athens University, Evgenidion Hospital, Papadiamantopoulou 20, Athens, Greece. abetrosian@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acinetobacter Infections
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drug therapy*,
microbiology Acinetobacter baumannii / drug effects* Aged Ampicillin / pharmacology, therapeutic use Anti-Bacterial Agents / pharmacology, therapeutic use* Colistin / pharmacology, therapeutic use Drug Resistance, Multiple, Bacterial Female Humans Male Middle Aged Pneumonia, Bacterial / drug therapy*, microbiology Pneumonia, Ventilator-Associated / drug therapy* Sulbactam / pharmacology, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 1066-17-7/Colistin; 68373-14-8/Sulbactam; 69-53-4/Ampicillin; 76497-13-7/sultamicillin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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