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654. Clinical efficacy and safety of high dose Ampicillin sulbactam among patients with CRAB infections: A case series

A. Warrier, R. Sneha, Arun Wilson, Shilpa Prakash

Open Forum Infectious Diseases, 2022

12 participants · 1 citation

Abstract

CRAB continues to threaten the healthcare facilities in developing nations and is one among the commonest causes of hospital acquired infections in our hospital. In December 2021, the IDSA published the AMR guidance 2.0, that stated Ampicillin- sulbactam as the first choice for treating CRAB infections. We review the clinical outcomes with adherence to this guideline in our setting.

A descriptive study from India (January 2022 to April 2022), of in-patients who have received ampicillin sulbactam monotherapy or combination for CRAB infections. A standard treatment guideline for the identification and management of CRAB infections was introduced to the clinicians based on the AMR guidance 2.0 of IDSA. CRAB infections were classified as mild to severe based on clinical and radiological parameters. We collected the data on patients who were started on ampicillin sulbactam, given in a high dose (27g per day or renally adjusted) as a 4-hour infusion either alone or as combination with other antibiotics for the indication of CRAB infections.

Ampicillin-Sulbactam was started for 12 patients with CRAB infection. 2 of these patients were discharged while on treatment and hence, excluded. 6 out of the 10 patients were being treated for CRAB associated hospital acquired pneumonia, whereas the other indications included urinary tract infection, post neurosurgical meningitis and skin and soft tissue infections. Susceptibility testing to Ampicillin-Sulbactum was not possible in our…

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