Is Tigecycline a Good Choice in the Treatment of Multidrug-ResistantAcinetobacter baumanniiPneumonia?

Abstract

The aim of this study was to evaluate the efficacy of tigecycline in multidrug-resistant (MDR) Acinetobacter baumannii pneumonia. We retrospectively evaluated the outcome of adult patients with culture proven MDR A. baumannii pneumonia treated with tigecycline between January 2009 and March 2011. The study comprised a total of 72 MDR A. baumannii pneumonia cases (44 men, mean age 65.9±15.0). Tigecycline was used for a mean duration of 10.7±4.8 days. Microbiological eradication was observed in 47 cases (65.3%). Overall mortality was 55.5% and was lower in cases with microbiological eradication vs others (15/47 32% vs 25/25 100%, p<0.0001). Mortality and microbiological eradication rates were not different with monotherapy vs combination therapy (p>0.05). Patients who died had lower albumin levels, higher APACHE-II scores and CRP levels. The microbiological eradication rate of tigecycline in MDR A. baumannii was considerable. However, eradication of A. baumannii did not result in favorable clinical outcomes in those patients with low albumin, higher APACHE-II scores and CRP levels.

Increasing resistance of nosocomial Acinetobacter baumannii: are we going to be defeated?

“…In another study performed at the Konya Education and Research Hospital, imipenem resistance was reported as 50% in 2008 and 83% in 2010 (17). The imipenem resistance rate was found as 91.7% in the Acinetobacter isolates that were responsible for ventilatorassociated pneumonia between January 2009 and January and March 2011 by Tasbakan et al (18). When compared to other studies, the lower resistance rates in our hospital in 2008 may be related to the fact that patients have only been admitted to ICUs since the beginning of 2007.…”

“…The resistance rate of netilmicin was reported as 24.9% in a study performed by Özdemir et al (15). Tasbakan et al reported a 54.2% netilmicin resistance rate in the isolates that were the responsible agents of ventilator-associated pneumonia between 2009 and 2011 (18). The resistance rate was reported as 71% in another study performed by Mansur et al (14).…”

“…The resistance rate of cefoperazone/ sulbactam was reported as 63.9% for Acinetobacter spp. (18,19). Sulbactam seems to be a potential alternative agent in the treatment of multidrug-resistant Acinetobacter infections due to the intrinsic activity against these isolates (20)(21)(22).…”

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

“…Previous studies have suggested favorable clinical outcomes with the treatment of TGC or TGC combinations (5)(6)(7)(8). There are few alternative antibiotics that are effective against XDR A. baumannii.…”

Multidrug Resistance Among A. baumannii Isolates from Intensive Care Unit: A Four Years Retrospective Study

“…Tasbakan et al reported lower albumin and higher CRP levels in nonsurvival cases. 34 Zilberberg et al reported that hyponatremia was associated with increased mortality. 35 We did not find any significant effect of laboratory parameters (Na, BUN, albumin, creatinine, hemoglobin, WBC and CRP) on mortality.…”