title: Severe nosocomial infections with imipenem-resistant Acinetobacter baumannii treated with ampicillin/sulbactam.
abstract: Forty consecutive patients with nosomial infections caused by multidrug-resistant Acinetobacter baumannii were treated with intravenous ampicillin/sulbactam. The infections were primary bloodstream (32.5%), pneumonia (30%), urinary tract (15%), peritonitis (7.5%), surgical site (7.5%), meningitis (5%) and sinusitis (2.5%). Most were severe infections with underlying conditions (median APACHE II score: 14.5) and 72.5% occurred in the ICU. Twenty-seven (67.5%) were improved/cured, seven (17.5%) were failures and six (15%) were considered to have an indeterminate outcome because patients died within the first 48 h of treatment. Two cases of meningitis were treated and did not respond. The median daily dose of ampicillin/sulbactam was 6 g/3 g and six patients received 12 g/6 g. No adverse effects were observed. This study indicates that ampicillin/sulbactam may be a good and safe therapeutic option to treat severe nosocomial infections caused by multi-drug resistant A. baumannii.
authors.affiliation: Nosocomial Infection Control Department, Hospital das Clínicas, University of São Paulo, Rua Harmonia 564/52, São Paulo, SP 05435-000, Brazil. gcih@hcnet.usp.br
authors.forename: Anna S
authors.initials: AS
authors.lastname: Levin
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Levy
authors.forename: A Edison I
authors.initials: AE
authors.lastname: Manrique
authors.forename: Eduardo A S
authors.initials: EA
authors.lastname: Medeiros
authors.forename: Silvia F
authors.initials: SF
authors.lastname: Costa
mesh_terms: D000151:Acinetobacter Infections / Q000178:diet therapy*; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000627:therapeutic use*; D002648:Child; D003428:Cross Infection / Q000188:drug therapy*; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015378:Imipenem / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D013407:Sulbactam / Q000627:therapeutic use*
chemical_list: C035444:sultamicillin; D015378:Imipenem; D000667:Ampicillin; D013407:Sulbactam