title: The minimal inhibitory concentration for sulbactam was not associated with the outcome of infections caused by carbapenem-resistant Acinetobacter sp. treated with ampicillin/sulbactam.
abstract: OBJECTIVE
  The objective of this study was to evaluate whether the outcomes of carbapenem-resistant Acinetobacter infections treated with ampicillin/sulbactam were associated with the in vitro susceptibility profiles.
  
  
  METHODS
  Twenty-two infections were treated with ampicillin/sulbactam. The median treatment duration was 14 days (range: 3-19 days), and the median daily dose was 9 g (range: 1.5-12 g). The median time between Acinetobacter isolation and treatment was 4 days (range: 0-11 days).
  
  
  RESULTS
  The sulbactam minimal inhibitory concentration (MIC) ranged from 2.0 to 32.0 mg/L, and the MIC was not associated with patient outcome, as 4 of 5 (80%) patients with a resistant infection (MIC≥16), 5 of 10 (50%) patients with intermediate isolates (MIC of 8) and only 1 of 7 (14%) patients with susceptible isolates (MIC ≤4) survived hospitalization.
  
  
  CONCLUSIONS
  These findings highlight the need to improve the correlation between in vitro susceptibility tests and clinical outcome.
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Department of Infection Control, Universidade de São Paulo, São Paulo/SP, Brazil. mauraoliveira@yahoo.com.br
authors.forename: Maura S de
authors.initials: MS
authors.lastname: Oliveira
authors.forename: Silvia Figueiredo
authors.initials: SF
authors.lastname: Costa
authors.forename: Ewerton de
authors.initials: Ed
authors.lastname: Pedri
authors.forename: Inneke
authors.initials: I
authors.lastname: van der Heijden
authors.forename: Anna Sara S
authors.initials: AS
authors.lastname: Levin
mesh_terms: D000150:Acinetobacter / Q000187:drug effects*; D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D015780:Carbapenems / Q000008:administration & dosage; D002648:Child; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D013407:Sulbactam / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D000667:Ampicillin; D013407:Sulbactam