Regimens and Clinical Outcomes of Antimicrobial Uses in Hospital-Acquired Pneumonia Caused by Drug Resistant Acinetobacter baumannii
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Abstract
Objective: To study antimicrobial regimens, clinical outcomes and adverse drug reactions (ADRs) of antimicrobials for the treatment of hospital-acquired pneumonia caused by multidrug-resistant Acinetobacter baumannii (MDR A. baumannii) and extensively drug-resistant A. baumannii (XDR A. baumannii). Methods: The researchers retrospectively collected the data from electronic medical records of patients in the medical ward at Maharat Nakhon Ratchasima hospital from July-December 2016 Results: There were 94 elegible patients in the study. A total of 17 antimicrobial regimens were found with the combination of colistin and carbapenems being the most commonly used antimicrobial regimen (31 patients or 33.0%). Four of those receiving colistin and carbapenems were clinically improved after 72 hours of antimicrobial treatment. At the end of antimicrobial treatment, 8 were clinically cure and 22 were dead. Clinical outcomes were not significantly different between those with and without colistin in the treatment. Mortality rate was significantly lower with combination therapy compared with monotherapy (P=0.049). ADRs were found in 13 patients (13.8%). The majority of ADR was nephrotoxicity found in 11 out of 37 patients receiving colistin injection. Conclusion: The most commonly used antimicrobial regimen for hospital-acquired pneumonia with MDR A. baumannii and XDR A. baumannii infections was a combination of colistin and carbapenem. However, clinical outcomes were rather poor. Those receiving intravenous colistin should be monitored for nephrotoxicity.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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