Journal of Antimicrobial Chemotherapy, Vol 42, 793-802, Copyright © 1998 by The British Society for Antimicrobial Chemotherapy
X Corbella, J Ariza, C Ardanuy, M Vuelta, F Tubau, M Sora, M Pujol and F Gudiol
From March 1995 to March 1997, sulbactam was prospectively evaluated in
patients with non-life-threatening multiresistant Acinetobacter baumannii
infections. During this period, 47 patients were treated with sulbactam; of
them, five were excluded because they had received < or =48 h of
sulbactam therapy. A total of 42 patients, 27 males and 15 females with a
mean age of 60+/-15 years, were finally evaluated. Infections were as
follows: surgical wound, 19; tracheobronchitis, 12; urinary tract, 7;
catheter-related bacteraemia, 2; and pneumonia, 2. Eighteen patients
received intravenous sulbactam alone (1 g every 8 h) and 24 patients
received intravenous sulbactam/ampicillin (1 g:2 g every 8 h) with no major
adverse effects. Of the 42 patients, 39 improved or were cured and showed
A. baumannii eradication and one patient had persistence of wound infection
after 8 days of sulbactam/ampicillin requiring surgical debridement. Two
patients died after 3 days of therapy (one of the deaths was attributable
to A. baumannii infection). The in-vitro activity of the
sulbactam/ampicillin combination was by virtue of the antimicrobial
activity exhibited by sulbactam. Killing curves showed that sulbactam was
bacteriostatic; no synergy was observed between ampicillin and sulbactam.
Our results indicate that sulbactam may prove effective for
non-life-threatening A. baumannii infections. Its role in the treatment of
severe infections is unknown. However, the current formulation of sulbactam
alone may allow its use at higher doses and provide new potential synergic
combinations, particularly for those infections by A. baumannii resistant
to imipenem.
Efficacy of sulbactam alone and in combination with ampicillin in nosocomial infections caused by multiresistant Acinetobacter baumannii [In Process Citation]
Department of Infectious Diseases, Hospital de Bellvitge, University of Barcelona, Spain. xcorbella@csub.scs.es
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