Meropenem/colistin versus meropenem/ampicillin-sulbactam in the treatment of carbapenem-resistant pneumonia

J Comp Eff Res. 2018 Sep;7(9):901-911. doi: 10.2217/cer-2018-0037. Epub 2018 Sep 7.

Abstract

Aim: Efficacy of colistin and ampicillin-sulbactam have not been compared in treatment of ventilator-associated pneumonia due to A. baumannii. Efficacy of colistin and ampicillin-sulbactam in combination with meropenem were compared in treatment of ventilator-associated pneumonia due to carbapenem-resistant A. baumannii.

Method: 47 patients with ventilator-associated pneumonia due to carbapenem-resistant A. baumannii were randomized to receive meropenem/colistin or meropenem/ampicillin-sulbactam for 14 days. Clinical and microbiological responses and 28-day mortality were considered as outcomes.

Results: Clinical response (75 vs 69.6%; p = 0.75) and microbial eradication (87.50 vs 91.3%; p = 0.59) were comparable between meropenem/colistin and meropenem/ampicillin-sulbactam groups, respectively.

Conclusion: In this study, clinical and microbiological response were comparable between the meropenem/colistin and meropenem/ampicillin-sulbactam groups.

Keywords: Acinetobacter; ampicillin–sulbactam; colistin; pneumonia.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinetobacter Infections / drug therapy
  • Acinetobacter baumannii
  • Aged
  • Ampicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use*
  • Carbapenems / therapeutic use
  • Colistin / therapeutic use
  • Drug Combinations
  • Drug Resistance, Bacterial
  • Female
  • Humans
  • Male
  • Meropenem / therapeutic use
  • Middle Aged
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Ventilator-Associated / drug therapy*
  • Sulbactam / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Drug Combinations
  • sultamicillin
  • Ampicillin
  • Meropenem
  • Sulbactam
  • Colistin