Epidemiology, resistance, and outcomes of Acinetobacter baumannii bacteremia treated with imipenem-cilastatin or ampicillin-sulbactam.
OBJECTIVE
To evaluate epidemiology, resistance, and treatment outcomes of Acinetobacter baumannii bacteremia treated with imipenem-cilastatin or ampicillin-sulbactam for 72 hours or longer.


METHODS
Retrospective analysis.


METHODS
University teaching hospital.


METHODS
Forty-eight patients with A. baumannii bacteremia.


METHODS
Evaluation of susceptibility and clinical data from 48 patients treated with either ampicillin-sulbactam or imipenem-cilastatin from 1987-1999.


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).


CONCLUSIONS
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.
Jellison
T K
TK
Department of Pharmacy Services, Detroit Receiving Hospital, Wayne State University, Michigan 48201, USA.
Mckinnon
P S
PS
Rybak
M J
MJ
D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000191:economics / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D016009:Chi-Square Distribution; D015377:Cilastatin / Q000191:economics / Q000627:therapeutic use*; D000077728:Cilastatin, Imipenem Drug Combination; D004338:Drug Combinations; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015378:Imipenem / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013407:Sulbactam / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
D004338:Drug Combinations; D015377:Cilastatin; C035444:sultamicillin; D015378:Imipenem; D000667:Ampicillin; D000077728:Cilastatin, Imipenem Drug Combination; D013407:Sulbactam