期刊
ANTIBIOTICS-BASEL
卷 11, 期 8, 页码 -出版社
MDPI
DOI: 10.3390/antibiotics11081112
关键词
A; baumannii XDR pneumonia; mortality rate; colistin; sulbactam
资金
- Siam pharmaceutical
Extensively drug-resistant A. baumannii (XDRAB) pneumonia has a high mortality rate. This study compared the efficacy of combination treatment with colistin and sulbactam at a dosage of either 9 g/day or 12 g/day. The results did not show superiority of the 12 g/day dosage over the 9 g/day dosage. However, this trial was underpowered to detect mortality differences due to being an interim analysis.
Extensively drug-resistant A. baumannii (XDRAB) pneumonia has a high mortality rate in hospitalized patients. One of the recommended treatments is colistin combined with sulbactam; however, the optimal dosage of sulbactam is unclear. In an open-label, superiority, randomized controlled trial, patients diagnosed with XDRAB pneumonia were randomly assigned (1:1) to receive colistin in combination with sulbactam at either 9 g/day or 12 g/day. The primary outcome was the 28-day mortality rate in the intention-to-treat population. A total of 88 patients received colistin in combination with sulbactam at a dosage of either 12 g/day (n = 45) or 9 g/day (n = 43). Trends toward a lower mortality rate were observed in the 12 g/day group at 7 days (11.1% vs. 23.3%), 14 days (33.3% vs. 41.9%), and 28 days (46.7% vs. 58.1%). The microbiological cure rate at day 7 was significantly higher in the 12 g/day group (90.5% vs. 58.1%; p = 0.02). Factors associated with mortality at 28 days were asthma, cirrhosis, APACHEII score >= 28, and a dosage of sulbactam of 9 g/day for mortality at any timepoint. Treatment with colistin combined with sulbactam at 12 g/day was not superior to the combination treatment with sulbactam at 9 g/day. However, due to being an interim analysis, this trial was underpowered to detect mortality differences.
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