Antimicrobial Treatment and Clinical Outcomes of Carbapenem-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia

Chan, Jeannie D.; Graves, Joseph A.; Dellit, Timothy H.

doi:10.1177/0885066610377975

Cited by 79 publications

(77 citation statements)

References 23 publications

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“…Indeed, the effect of TGC combination therapy for bacteremia or bloodstream infection caused by MDR A. baumannii has been reported in previous studies (5,15) and case reports of septic shock patients complicated with trauma and acute pancreatitis (21,22). The addition of TGC to conventional therapy in patients with XDR A. baumannii-associated VAP decreased the incidence of septic shock, as first reported in the current study.…”

Section: Discussionsupporting

confidence: 82%

“…We reported clinical cures in only 50% of patients treated with TGC combination therapy compared with the 45.8% of patients treated with non-TGC conventional antibiotics. Our clinical cure rate was lower than reported (84-90%) in previous studies for carbapenem-resistant A. baumannii (5,15). Possible explanations for the relatively low clinical cure rate may be attributed to varying resistance of A. baumannii, and the relatively low-dose of TGC therapy.…”

Section: Discussioncontrasting

confidence: 81%

“…In previous studies, among 42 critically ill patients, TGC (in combination with other antibiotics in 28 patients) was effective in 32 patients (76%), but resistance to TGC developed in 3 patients during treatment (16). In another study, 4 of 6 clinical isolates developed intermediate resistance to TGC after initiation of therapy (15). In our cohort, 10 of 20 patients (50%) developed resistance to TGC after initiation of therapy.…”

Section: Discussionsupporting

confidence: 46%

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Tigecycline combination for ventilator-associated pneumonia caused by extensive drug-resistant Acinetobacter baumannii

He¹,

Zheng²,

Sun³

et al. 2016

J. Thorac. Dis.

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Background: Extensive drug-resistant Acinetobacter baumannii (XDR A. baumannii) has emerged as an important pathogen in patients with ventilator-associated pneumonia (VAP) worldwide. This study determined whether or not combination tigecycline (TGC) treatment improved the short-term outcome of patients with XDR A. baumannii-induced VAP. Methods: Fifty-eight patients admitted to our intensive care unit (ICU) with confirmed XDR A. baumannii VAP between January 2011 and June 2013 were retrospectively studied. Fourteen patients were excluded. The included subjects were classified into two groups depending on treatment regimens with or without TGC (TGC group, n=20; non-TGC group, n=24). Thirty-day mortality rates, and clinical and microbiologic responses were reviewed and compared in detail.

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Section: Discussionsupporting

confidence: 82%

Section: Discussioncontrasting

confidence: 81%

Section: Discussionsupporting

confidence: 46%

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Tigecycline combination for ventilator-associated pneumonia caused by extensive drug-resistant Acinetobacter baumannii

He¹,

Zheng²,

Sun³

et al. 2016

J. Thorac. Dis.

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“…The clinical cure rate of VAP patients receiving colistin alone or combined with other antibiotics has been reported to be highly variable, between 15% and 85.7% [17][18][19][20][21][22]. In our study, the rate was found to be 64.2%.…”

Section: Discussionmentioning

confidence: 37%

Colistin alone or combined with sulbactam or carbapenem against A. baumannii in ventilator-associated pneumonia

Yilmaz

Güven

Güner

et al. 2015

J Infect Dev Ctries

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Introduction: Colistin use has increased over the last ten years because of multidrug-resistant microorganisms. The aim of this study was to compare the clinical and microbiological efficacy of colistin alone or in combination with sulbactam or carbapenem in the treatment of ventilator-associated pneumonia (VAP) due to multidrug-resistant (MDR) and extremely drug-resistant (XDR) A. baumannii. Methodology: Cases treated for VAP because of MDR and XDR A. baumannii between January 2011 and January 2013 were included in the study. The primary and secondary outcome for colistin alone, colistin with sulbactam, and colistin with carbapenems were evaluated. The primary outcomes were clinical efficacy and microbiological efficacy; the secondary outcomes were nephrotoxicity, length of hospitalization, and mortality. Results: A total of 70 VAP patients were evaluated. A total of 17 patients (24.3%) were administered colistin alone, 20 patients (28.6%) were administered colistin and sulbactam, and 33 patients (47.1%) were administered colistin and carbapenem. Clinical and microbiological response rates were higher in the carbapenem combination group (63.6% and 63.6% in both) than in the sulbactam combination group, which registered 55.0% and 60.0%, respectively. However, this did not represent a significant difference statistically (p > 0.05). There was also no significant difference between colistin alone and the combination groups regarding clinical and microbiological efficacy and mortality. Conclusions: Neither the administration of colistin alone nor colistin combined with either sulbactam or carbapenem had any noticeable advantage in the treatment of VAP in terms of clinical response, microbiological response, nephrotoxicity, length of hospitalization, and mortality.

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“…infection emerges. 7) Though the expected neurotoxicity and nephrotoxicity was not high compared with the previous reports, 8) it will be still appropriate to do close monitoring and dose modification in the patients with decreased renal function because nephrotoxicity is still the most frequent adverse events.…”

mentioning

confidence: 95%

Efficacy and Safety Profile Comparison of Colistin and Tigecycline on the Extensively Drug Resistant <i>Acinetobacter baumannii</i>

Kwon

Ahn

Han

et al. 2014

Biological & Pharmaceutical Bulletin

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Colistin and tigecycline are the only therapeutic options for extensively drug resistant Acinetobacter baumannii (XDR-AB), but there is little comparative study. This retrospective observation study evaluated two-colistin and tigecycline-antibiotics profiles like treatment success rate, negative conversion rate, the length of hospital stay, intensive care unit (ICU) stay and antibiotics use, mortality rate during hospital stay and adverse event rate, based on the medical record of XDR-AB positive patients who were treated at least 5 d with those intravenous antibiotics. Treatment success rate of colistin (n 39) and tigecycline (n 16) were not different: 48.7% and 43.8%, respectively (p 0.737), though negative conversion rate was significantly higher in the colistin group: 46.2% against 12.5% (p 0.049). There was no statistically significant difference in mortality rate between two groups during hospital stay (43.6% vs. 56.3%, p 0.393). There were no significant differences in the following parameters: the median length of hospital stay ( The colistin group showed serum creatinine elevation (defined as elevation more than 2.0 mg/dL and 50% increase from the baseline) as 43.6% when compared with 12.5% of the tigecycline group ( p 0.028). As a therapeutic option of XDR-AB, colistin showed significantly better negative conversion rate than tigecycline with more frequent nephrotoxic prevalence, and treatment success rate and mortality rate were not different from both antibiotics groups.

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Antimicrobial Treatment and Clinical Outcomes of Carbapenem-Resistant Acinetobacter baumannii Ventilator-Associated Pneumonia

Cited by 79 publications

References 23 publications

Tigecycline combination for ventilator-associated pneumonia caused by extensive drug-resistant Acinetobacter baumannii

Tigecycline combination for ventilator-associated pneumonia caused by extensive drug-resistant Acinetobacter baumannii

Colistin alone or combined with sulbactam or carbapenem against A. baumannii in ventilator-associated pneumonia

Efficacy and Safety Profile Comparison of Colistin and Tigecycline on the Extensively Drug Resistant <i>Acinetobacter baumannii</i>

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