Clinical outcomes of cephalosporins, meropenem, and colistin-based regimens in the treatment of pneumonia caused by A. baumannii infection in secondary care hospitals in Thailand: A retrospective study

Abstract

As there has been inconsistency in the clinical outcomes of antibiotic treatment for Acinetobacter baumannii infection, particularly in secondary care hospitals, this study aimed to investigate the clinical outcomes and mortality rates of patients with such conditions who received different types of antibiotics. Methods: All medication charts of patients who were admitted to the settings due to pneumonia, which was caused by Acinetobacter baumannii infection, between 1 January 2017 and 31 August 2020 were reviewed. Patient data were collected, including the used antibiotics, clinical cure at the end of the treatment course, and mortality status. Kaplan-Meier curve with log-rank test was used to analyse the results of each antibiotic regimen. Results: There were 43, 35, and 26 patients who were recruited to cephalosporins, meropenem, and colistin groups, respectively. Baseline characteristics of the three groups were similar, including gender, age, comorbid diseases, and laboratory values. The majority of them were infected with carbapenem-resistant and multidrug-resistant Acinetobacter baumannii. The results indicated that clinical cure rates of cephalosporins, meropenem and colistin treatments were not significantly different (58.14%, 48.57%, and 38.46%, respectively, p-value 0.279). Moreover, the mortality rates of all were not significantly different (34.88%, 51.43%, and 50.00%, respectively, p-value 0.271). Acute kidney injury was observed in four patients using colistin but not other antibiotics. Conclusion: This study highlighted a non-significant difference in clinical cure and mortality rates among cephalosporins, meropenem, and colistin in patients infected with Acinetobacter baumannii in secondary care hospitals in Thailand.