title: Colistin vs. the combination of colistin and rifampicin for the treatment of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia.
abstract: The aim of this study was to compare the responses of colistin treatment alone vs. a combination of colistin and rifampicin in the treatment of ventilator-associated pneumonia (VAP) caused by a carbapenem-resistant A. baumannii strain. Forty-three patients were randomly assigned to one of two treatment groups. Although clinical (P = 0·654), laboratory (P = 0·645), radiological (P = 0·290) and microbiological (P = 0·597) response rates were better in the combination group, these differences were not significant. However, time to microbiological clearance (3·1 ± 0·5 days, P = 0·029) was significantly shorter in the combination group. The VAP-related mortality rates were 63·6% (14/22) and 38·1% (8/21) for the colistin and the combination groups (P = 0·171), respectively. Our results suggest that the combination of colistin with rifampicin may improve clinical and microbiological outcomes of VAP patients infected with A. baumannii.
authors.affiliation: Bulent Ecevit University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Zonguldak, Turkey. drhaydemir@yahoo.com
authors.forename: H
authors.initials: H
authors.lastname: Aydemir
authors.forename: D
authors.initials: D
authors.lastname: Akduman
authors.forename: N
authors.initials: N
authors.lastname: Piskin
authors.forename: F
authors.initials: F
authors.lastname: Comert
authors.forename: E
authors.initials: E
authors.lastname: Horuz
authors.forename: A
authors.initials: A
authors.lastname: Terzi
authors.forename: F
authors.initials: F
authors.lastname: Kokturk
authors.forename: T
authors.initials: T
authors.lastname: Ornek
authors.forename: G
authors.initials: G
authors.lastname: Celebi
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use; D003091:Colistin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy* / Q000382:microbiology; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D012293:Rifampin; D003091:Colistin