Price Analysis of HIV Antiretroviral Drugs Marketed In The United States (1987-2015)

Abstract

objeCtives: The prevalence of carbapenem-resistant Acinetobacter baumannii (CRAB) is emerging in the intensive care units (ICUs) in Taiwan. Pneumonia is a common site of CRAB infection and associated with high mortality in critically ill patients. The aims of this study were to study the epidemiology and treatment outcomes associated with different treatment strategies of CRAB pneumonia. Methods: We conducted a multicenter retrospective study on adults (≥ 20 years) patients with CRAB pneumonia in the medical ICUs of three hospitals, including a medical center and two regional hospitals in Southern Taiwan during 2010-2015. The data were collected for patient characteristics, prescribing patterns, drug resistant patterns, and treatment outcomes. Results: A. baumannii accounted for about 13% of all isolates in the MICUs, and up to 86% of them were CRAB. The prevalence of CRAB was continuously increasing during the study period. More than 94% of the CRAB were susceptible to tigecycline and colistin. Of the 215 patients with CRAB pneumonia included in the analyses for treatment effectiveness, 84 (39%) were treated with tigecycline monotherapy, 42 (20%) with tigecycline combined with colistin, 34 (16%) with colistin monotherapy, 28 (13%) with colistin combination, and 27 (13%) with tigecycline combination. Patients treated with tigecycline monotherapy had significantly higher mortality rate than colistin monotherapy (p = 0.04). ConClusions: CRAB was emerging in the MICUs in Taiwan. Tigecycline was the most common antibiotic prescribed for CRAB pneumonia patients; however, tigecycline monotherapy was associated with significantly higher mortality rate than colistin monotherapy.