Epidemiology, resistance, and outcomes of Acinetobacter baumannii bacteremia treated with imipenem-cilastatin or ampicillin-sulbactam.

Authors

Jellison TK, Mckinnon PS, Rybak MJ

Institution

Department of Pharmacy Services, Detroit Receiving Hospital, Wayne State University, Michigan 48201, USA.

Source

Pharmacotherapy 2001 Feb; 21(2) :142-8.

Abstract

STUDY OBJECTIVE
To evaluate epidemiology, resistance, and treatment outcomes of Acinetobacter baumannii bacteremia treated with imipenem-cilastatin or ampicillin-sulbactam for 72 hours or longer.
DESIGN
Retrospective analysis.
SETTING
University teaching hospital.
PATIENTS
Forty-eight patients with A. baumannii bacteremia.
INTERVENTION
Evaluation of susceptibility and clinical data from 48 patients treated with either ampicillin-sulbactam or imipenem-cilastatin from 1987-1999. MEASUREMENTS and
MAIN RESULTS
Comparing ampicillin-sulbactam and imipenem-cilastatin, there were no differences between days of bacteremia (4 vs 2 days, p=0.05), days to resolution of temperature or white blood cell count, success or failure during or at end of treatment, or intensive care unit total or antibiotic-related length of stay (13 vs 10 days, p=0.05). Patients treated with ampicillin-sulbactam had significantly decreased antibiotic treatment costs (1500 dollars vs 500 dollars, p=0.004).
CONCLUSION
Ampicillin-sulbactam is at least as effective as imipenem-cilastatin based on clinical response at days 2, 7, and end of treatment and is a cost-effective alternative for treatment of A. baumannii infections.